Provider Demographics
NPI:1912725870
Name:BETH ISRAEL HOMECARE INC
Entity type:Organization
Organization Name:BETH ISRAEL HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-206-2819
Mailing Address - Street 1:41 MOTT ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5041
Mailing Address - Country:US
Mailing Address - Phone:212-796-2018
Mailing Address - Fax:
Practice Address - Street 1:41 MOTT ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5041
Practice Address - Country:US
Practice Address - Phone:212-796-2018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH ISRAEL HOMECARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health