Provider Demographics
NPI:1871677252
Name:NORTH GENERAL HOME ATTENDANT CORP.
Entity Type:Organization
Organization Name:NORTH GENERAL HOME ATTENDANT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-289-2565
Mailing Address - Street 1:205 E 122ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2200
Mailing Address - Country:US
Mailing Address - Phone:212-427-3330
Mailing Address - Fax:212-534-1856
Practice Address - Street 1:205 E 122ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2200
Practice Address - Country:US
Practice Address - Phone:212-427-3330
Practice Address - Fax:212-534-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9555L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00926081Medicaid
NY02141679Medicaid