Organization
EXTENDED NURSING PERSONNEL CHHA, LLC
Active
Other names
Extended Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN DIANA (ADMINISTRATOR)
(212) 356-4200
Entity
Organization
Contact information
Practice address
2003 CONEY ISLAND AVE FL 3, BROOKLYN, NY 11223-2328
(212) 356-4200
(917) 793-4279
Mailing address
2003 CONEY ISLAND AVE FL 3, BROOKLYN, NY 11223-2328
(212) 356-4200
(917) 793-4279
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7002653
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01973037
—
NY
Enumeration date
09/27/2006
Last updated
03/28/2024
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