Provider Demographics
NPI:1396288775
Name:BRIGHTON HOME CARE
Entity type:Organization
Organization Name:BRIGHTON HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/DPS
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISRAILOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-368-4000
Mailing Address - Street 1:1600 SHEEPSHEAD BAY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3847
Mailing Address - Country:US
Mailing Address - Phone:718-368-4000
Mailing Address - Fax:718-368-4001
Practice Address - Street 1:1600 SHEEPSHEAD BAY RD STE 203
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3847
Practice Address - Country:US
Practice Address - Phone:718-368-4000
Practice Address - Fax:718-368-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2268L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04519962Medicaid