1831264001 NPI number — SELFHELP COMMUNITY SERVICES HOME ATTENDANT CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831264001 NPI number — SELFHELP COMMUNITY SERVICES HOME ATTENDANT CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SELFHELP COMMUNITY SERVICES HOME ATTENDANT CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831264001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 8TH AVE.
Provider Second Line Business Mailing Address:
5 TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-6553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-971-7600
Provider Business Mailing Address Fax Number:
212-629-9482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 8TH AVE.
Provider Second Line Business Practice Location Address:
5 TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10018-6553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-971-7600
Provider Business Practice Location Address Fax Number:
212-629-9482
Provider Enumeration Date:
11/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEIDLER
Authorized Official First Name:
TAMI
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST. VP, OPERATIONS
Authorized Official Telephone Number:
212-971-7664

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  0868L001 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00922216 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00912348 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".