Provider Demographics
NPI:1770598500
Name:NYS HOME HEALTH, LLC
Entity type:Organization
Organization Name:NYS HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZAUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GASANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-934-7060
Mailing Address - Street 1:5550 GRANITE PKWY STE 265
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3726
Mailing Address - Country:US
Mailing Address - Phone:972-934-7060
Mailing Address - Fax:214-575-2777
Practice Address - Street 1:5550 GRANITE PKWY STE 265
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3726
Practice Address - Country:US
Practice Address - Phone:972-934-7060
Practice Address - Fax:214-575-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
TX014070251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164364502Medicaid
TX001014400Medicaid
TX001014401Medicaid
TX001014401Medicaid