Provider Demographics
NPI:1972560365
Name:ENS HEALTH CARE MANAGEMENT LLC
Entity Type:Organization
Organization Name:ENS HEALTH CARE MANAGEMENT LLC
Other - Org Name:INTERIM HEALTHCARE OF THE CAPITAL REGION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:518-452-3655
Mailing Address - Street 1:1735 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4758
Mailing Address - Country:US
Mailing Address - Phone:518-452-3655
Mailing Address - Fax:518-452-0765
Practice Address - Street 1:1735 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4758
Practice Address - Country:US
Practice Address - Phone:518-452-3655
Practice Address - Fax:518-452-0765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1063L001251E00000X
NY1063L002251E00000X
NY1063L003251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02200360Medicaid
NY02861741OtherTBI PROGRAM
NY1063L003OtherSARATOGA LICENSE #
NY02150443Medicaid
NY1063L002OtherGLENS FALLS LICENSE #
NY1063L001OtherLHCSA LICENSE NUMBER