Provider Demographics
NPI:1457580128
Name:SOBOLA ENTERPRISE & HOME CARE SERVICES INC.
Entity Type:Organization
Organization Name:SOBOLA ENTERPRISE & HOME CARE SERVICES INC.
Other - Org Name:SOBOLA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:BOSEDE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-627-1320
Mailing Address - Street 1:495 FLATBUSH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3782
Mailing Address - Country:US
Mailing Address - Phone:800-515-4640
Mailing Address - Fax:347-246-9551
Practice Address - Street 1:495 FLATBUSH AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3782
Practice Address - Country:US
Practice Address - Phone:800-515-4640
Practice Address - Fax:347-246-9551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1029L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1029L001OtherNEW YORK STATE DEPARTMENT OF HEALTH