Provider Demographics
NPI:1780934679
Name:NANNIES FOR GRANNIES INC
Entity type:Organization
Organization Name:NANNIES FOR GRANNIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:THELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-730-8500
Mailing Address - Street 1:34 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3418
Mailing Address - Country:US
Mailing Address - Phone:631-730-8500
Mailing Address - Fax:631-730-8560
Practice Address - Street 1:34 SUNSET LN
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3418
Practice Address - Country:US
Practice Address - Phone:631-730-8500
Practice Address - Fax:631-730-8560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1804-L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health