Provider Demographics
NPI:1336340371
Name:PERSONAL HOME CARE INC.
Entity Type:Organization
Organization Name:PERSONAL HOME CARE INC.
Other - Org Name:A-LETE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPS
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDBLAD
Authorized Official - Suffix:
Authorized Official - Credentials:N
Authorized Official - Phone:631-549-9500
Mailing Address - Street 1:775 PARK AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7516
Mailing Address - Country:US
Mailing Address - Phone:631-549-9500
Mailing Address - Fax:631-549-9508
Practice Address - Street 1:775 PARK AVE STE 155
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7516
Practice Address - Country:US
Practice Address - Phone:631-549-9500
Practice Address - Fax:631-549-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1227L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health