Provider Demographics
NPI:1154948651
Name:EASYCARE HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:EASYCARE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNBULL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENABULELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-288-9833
Mailing Address - Street 1:177 W PUTNAM AVE STE 2678
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:177 W PUTNAM AVE STE 2678
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5203
Practice Address - Country:US
Practice Address - Phone:718-288-9833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care