Provider Demographics
NPI:1982954251
Name:COMPLEX CARE SOLUTION
Entity Type:Organization
Organization Name:COMPLEX CARE SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-732-2638
Mailing Address - Street 1:75 BROAD ST
Mailing Address - Street 2:815
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2415
Mailing Address - Country:US
Mailing Address - Phone:931-455-2279
Mailing Address - Fax:267-393-7697
Practice Address - Street 1:1561 METROPOLITAN AVE
Practice Address - Street 2:APT 6A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6231
Practice Address - Country:US
Practice Address - Phone:347-293-6365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015916253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care