Provider Demographics
NPI:1134778814
Name:CASTLE ROCK HOME CARE INC
Entity type:Organization
Organization Name:CASTLE ROCK HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-916-7949
Mailing Address - Street 1:2011 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4507
Mailing Address - Country:US
Mailing Address - Phone:718-513-6641
Mailing Address - Fax:
Practice Address - Street 1:2011 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4507
Practice Address - Country:US
Practice Address - Phone:718-513-6641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health