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Organization
SURFSIDE MANOR HFA LHCSA
Active
Organization
SURFSIDE MANOR HFA LHCSA
Active
Other names
ExtraCare Home Care Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA MORGAN-PARKER RN (ADMINISTRATOR)
(718) 713-0004
Entity
Organization
Contact information
Practice address
214 BEACH 96TH ST, ROCKAWAY BEACH, NY 11693-1338
(718) 713-0004
(718) 713-0008
Mailing address
214 BEACH 96TH ST, ROCKAWAY BEACH, NY 11693-1338
(718) 713-0004
(718) 713-0008
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1150L001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1150L001
LICENSE NUMBER
NY
Enumeration date
01/12/2009
Last updated
01/12/2009
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