Provider Demographics
NPI:1801504782
Name:STATE HOMECARE INC.
Entity type:Organization
Organization Name:STATE HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAZI
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-1549
Mailing Address - Street 1:4144 75TH STREET
Mailing Address - Street 2:APT 3D
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-200-1549
Mailing Address - Fax:
Practice Address - Street 1:4144 75TH STREET
Practice Address - Street 2:APT 3D
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-200-1549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health