Provider Demographics
NPI:1457593857
Name:SHERRY KAY HOME CARE, INC.
Entity Type:Organization
Organization Name:SHERRY KAY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCOPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-856-9703
Mailing Address - Street 1:9 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-2806
Mailing Address - Country:US
Mailing Address - Phone:845-856-9703
Mailing Address - Fax:845-856-1070
Practice Address - Street 1:9 CENTER ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771-2806
Practice Address - Country:US
Practice Address - Phone:845-856-9703
Practice Address - Fax:845-856-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9257L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01582012Medicaid