Provider Demographics
NPI:1750742706
Name:AVEENA'S LOVING COMPANION CARE LLC
Entity type:Organization
Organization Name:AVEENA'S LOVING COMPANION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALKARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-775-1677
Mailing Address - Street 1:9115 181ST ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2311
Mailing Address - Country:US
Mailing Address - Phone:718-775-1677
Mailing Address - Fax:
Practice Address - Street 1:9115 181ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11423-2311
Practice Address - Country:US
Practice Address - Phone:718-775-1677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care