Provider Demographics
NPI:1285173526
Name:THERESA HOME CARE AGENCY INC
Entity type:Organization
Organization Name:THERESA HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VASHTI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMLOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-738-6700
Mailing Address - Street 1:110-08 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:NY
Mailing Address - Zip Code:11419
Mailing Address - Country:US
Mailing Address - Phone:718-738-6700
Mailing Address - Fax:718-843-0594
Practice Address - Street 1:110-08 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:NY
Practice Address - Zip Code:11419
Practice Address - Country:US
Practice Address - Phone:718-738-6700
Practice Address - Fax:718-843-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2133L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health