Provider Demographics
NPI:1982262523
Name:HEALTHY AND LONG LIFE CARE INC.
Entity Type:Organization
Organization Name:HEALTHY AND LONG LIFE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHUN KAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-321-0791
Mailing Address - Street 1:6072 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3446
Mailing Address - Country:US
Mailing Address - Phone:646-265-1090
Mailing Address - Fax:718-326-3388
Practice Address - Street 1:13608 38TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5412
Practice Address - Country:US
Practice Address - Phone:718-321-0791
Practice Address - Fax:718-353-3970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2105L001OtherLHCSA