Provider Demographics
NPI:1750897781
Name:RSGHOMEAGENCYCORP
Entity type:Organization
Organization Name:RSGHOMEAGENCYCORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ROBYLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-363-2799
Mailing Address - Street 1:8131 BAXTER AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1317
Mailing Address - Country:US
Mailing Address - Phone:929-363-2799
Mailing Address - Fax:
Practice Address - Street 1:8131 BAXTER AVE APT 4G
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1317
Practice Address - Country:US
Practice Address - Phone:929-363-2799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care