Provider Demographics
NPI:1932309242
Name:CLASSIC HOME CARE INC
Entity Type:Organization
Organization Name:CLASSIC HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:KWABEA
Authorized Official - Last Name:QUANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-881-2200
Mailing Address - Street 1:2655 WEBSTER AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-4270
Mailing Address - Country:US
Mailing Address - Phone:718-881-2200
Mailing Address - Fax:171-881-2205
Practice Address - Street 1:2655 WEBSTER AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-4270
Practice Address - Country:US
Practice Address - Phone:718-881-2200
Practice Address - Fax:171-888-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1390-L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health