Provider Demographics
NPI:1700944998
Name:PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.
Entity Type:Organization
Organization Name:PEOPLE HOME HEALTH CARE SERVICES CERTIFIED, INC.
Other - Org Name:PEOPLE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:716-566-4814
Mailing Address - Street 1:1219 N FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3230
Mailing Address - Country:US
Mailing Address - Phone:716-634-8132
Mailing Address - Fax:716-817-2509
Practice Address - Street 1:692 MILLERSPORT HWY
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14226-2401
Practice Address - Country:US
Practice Address - Phone:716-874-5600
Practice Address - Fax:716-566-4988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1451602251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01415654Medicaid
NY337266Medicare Oscar/Certification