Provider Demographics
NPI:1952834772
Name:SUBLIME HOME CARE, LLC
Entity Type:Organization
Organization Name:SUBLIME HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:VIVIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ-LEACOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-935-2330
Mailing Address - Street 1:4310 ROCKAWAY BEACH BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4310 ROCKAWAY BEACH BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1222
Practice Address - Country:US
Practice Address - Phone:917-935-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health