Provider Demographics
NPI:1255055786
Name:B-WELL HOME CARE AGENCY INC.
Entity type:Organization
Organization Name:B-WELL HOME CARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAROVLYANSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-730-3520
Mailing Address - Street 1:2104 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2104 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2911
Practice Address - Country:US
Practice Address - Phone:718-730-3520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B-WELL HOME CARE AGENCY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05784276Medicaid