Provider Demographics
NPI:1962246967
Name:SENIOR HOME AIDE SERVICES LLC
Entity type:Organization
Organization Name:SENIOR HOME AIDE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEIKH MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIM HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-949-5201
Mailing Address - Street 1:70 WAKE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-2390
Mailing Address - Country:US
Mailing Address - Phone:631-949-5201
Mailing Address - Fax:
Practice Address - Street 1:70 WAKE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2390
Practice Address - Country:US
Practice Address - Phone:631-949-5201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care