Provider Demographics
NPI:1841668365
Name:GOOD HOME HEALTH AIDE SERVICES LLC
Entity type:Organization
Organization Name:GOOD HOME HEALTH AIDE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LIC HHA
Authorized Official - Phone:917-861-7971
Mailing Address - Street 1:3110 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4902
Mailing Address - Country:US
Mailing Address - Phone:917-861-7971
Mailing Address - Fax:347-449-7241
Practice Address - Street 1:3110 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-4902
Practice Address - Country:US
Practice Address - Phone:917-861-7971
Practice Address - Fax:347-449-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00446329251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1699160614OtherMEDICARE