Provider Demographics
NPI:1881719078
Name:ETIENNE HOME CARE SERVICES,INC
Entity type:Organization
Organization Name:ETIENNE HOME CARE SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:ETIENNE
Authorized Official - Last Name:VILSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:718-287-4300
Mailing Address - Street 1:2920 CORTELYOU RD # A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6310
Mailing Address - Country:US
Mailing Address - Phone:718-287-4300
Mailing Address - Fax:
Practice Address - Street 1:2920A CORTELYOU RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226
Practice Address - Country:US
Practice Address - Phone:718-287-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1122L001314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility