Provider Demographics
NPI:1922120104
Name:MID-HUDSON MANAGED HOME CARE, INC.
Entity Type:Organization
Organization Name:MID-HUDSON MANAGED HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SYLCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-567-3022
Mailing Address - Street 1:243 ROUTE 17K
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-8310
Mailing Address - Country:US
Mailing Address - Phone:845-567-3022
Mailing Address - Fax:845-567-3015
Practice Address - Street 1:243 ROUTE 17K
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8310
Practice Address - Country:US
Practice Address - Phone:845-567-3022
Practice Address - Fax:845-567-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9762L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01740972Medicaid