Provider Demographics
NPI:1851440374
Name:LITSON HEALTH CARE., INC.
Entity Type:Organization
Organization Name:LITSON HEALTH CARE., INC.
Other - Org Name:WILLCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-891-1044
Mailing Address - Street 1:346 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1804
Mailing Address - Country:US
Mailing Address - Phone:716-856-7500
Mailing Address - Fax:716-856-7506
Practice Address - Street 1:726 E MAIN ST
Practice Address - Street 2:SUITE 501
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2653
Practice Address - Country:US
Practice Address - Phone:845-342-1661
Practice Address - Fax:845-342-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0790L001251E00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00878111Medicaid
NY00910590Medicaid