Provider Demographics
NPI:1952462806
Name:HOMEMAKERS OF STATEN ISLAND, INC.
Entity Type:Organization
Organization Name:HOMEMAKERS OF STATEN ISLAND, INC.
Other - Org Name:SAFEHARBOR HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-979-6900
Mailing Address - Street 1:1477 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1906
Mailing Address - Country:US
Mailing Address - Phone:718-979-6900
Mailing Address - Fax:
Practice Address - Street 1:1477 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1906
Practice Address - Country:US
Practice Address - Phone:718-979-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0046L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00944990Medicaid