Provider Demographics
NPI:1821325366
Name:DEPENDABLE HEALTHCARE SERVICES, LLC.
Entity Type:Organization
Organization Name:DEPENDABLE HEALTHCARE SERVICES, LLC.
Other - Org Name:DEPENDABLE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:U
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-491-9003
Mailing Address - Street 1:120 ARCADIA RD
Mailing Address - Street 2:
Mailing Address - City:HOPE VALLEY
Mailing Address - State:RI
Mailing Address - Zip Code:02832-1329
Mailing Address - Country:US
Mailing Address - Phone:401-491-9003
Mailing Address - Fax:401-491-9054
Practice Address - Street 1:1171 MAIN STREET,
Practice Address - Street 2:SUITE C
Practice Address - City:WYOMING
Practice Address - State:RI
Practice Address - Zip Code:02898
Practice Address - Country:US
Practice Address - Phone:401-491-9003
Practice Address - Fax:401-491-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHNC02342251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDE78467Medicaid
RIDE78468Medicaid
RIDE78467Medicaid