MISS MAXINE ROSEMARIE HARRIS (NPI# 1023377611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023377611 |
| Entity Type | Individual |
| Full Name | MISS MAXINE ROSEMARIE HARRIS |
| Practice Address |
220-08 109 Avenue Queens Village NY 11429 |
| Mailing Address |
22008 109th Ave Queens Village NY 11429-2515 |
| Practice Telephone | 9172267249 |
| Mailing Telephone | 9172267249 |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
460234-1 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NPI | TF7175290 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508110 | Maxine Delores Harris | Assisted Living Facility | 104 Martin Luther King Blvd, Arcola, MS 38722 | 2019-09-24 |
| 1508093204 | Maxine Barbara Harris | Social Worker | 7044 Amherst Ave, 1f, Saint Louis, MO 63130-2330 | 2009-06-19 |
| Street Address |
220-08 109 AVENUE |
| City | QUEENS VILLAGE |
| State | NY |
| Zip Code | 11429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679106199 | Cynthia Joseph | Nutritionist | 100-11 208th Street, Queens Village, NY 11429 | 2020-02-13 |
| 1457917338 | Latoya Coleman | Social Worker | 111-41 Colfax Street, Queens Village, NY 11429 | 2019-05-15 |
| 1194294801 | Nats Ny Inc | Pharmacy | 10311 Springfield Blvd, Queens Village, NY 11429 | 2018-11-26 |
| 1912430901 | Firmause Payen | Specialist | 98-35 211th Street, Queens Village, NY 11429 | 2017-04-06 |
| 1891238515 | Kristen Joassaint | Licensed Practical Nurse | 99-09 217th Lane, Queens Village, NY 11429 | 2016-11-29 |
| 1538615877 | Melissa Glenn | Social Worker | 221-26 111th Ave, Queens Village, NY 11429 | 2016-08-28 |
| 1295190627 | Apak Chiropractic | Chiropractor | 218-02 Hempstead Avenue, 2nd Floor, Queens Village, NY 11429 | 2015-12-30 |
| 1548636996 | Donetta Thomas | Licensed Practical Nurse | 20940 111th Avenue, Queens Village, NY 11429 | 2015-08-19 |
| 1407222920 | Elizabeth O Shodimu | Nutritionist | 110-16 Sutphin Blvd, 111-08 Witthoff Street, Queen's Village, NY 11429 | 2015-08-19 |
| 1669869582 | Koffi Kodoe | Skilled Nursing Facility | 21223 Hollis Ave, Queens Village, NY 11429 | 2015-04-17 |
| Find all providers in zip 11429 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548689508 | Bayview | Custodial Care Facility | 9965 211th Pl, Queens Village, NY 11429-1144 | 2014-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557828 | Kenwood Manor Inc | Custodial Care Facility | 141 Rockefeller Rd, Delmar, NY 12054-2221 | 2020-10-27 |
| 1336748383 | Jjj Yaut, LLC | Custodial Care Facility | 4806 Ny 52, Jeffersonville, NY 12748 | 2020-10-21 |
| 1528683463 | Hanmaum Daycare LLC | Custodial Care Facility | 3238 148th St, Flushing, NY 11354-3259 | 2020-06-16 |
| 1538700158 | Parkview Hfa, Inc. | Custodial Care Facility | 3200 Bronx Blvd, Bronx, NY 10467-6305 | 2019-10-04 |
| 1457903437 | Prime Social Day Care | Custodial Care Facility | 1918 1st Ave 1st Floor, New York, NY 10029 | 2019-07-10 |
| 1477116457 | Caroline S Reuben | Custodial Care Facility | 17108 Jamaica Ave, Jamaica, NY 11432-5428 | 2019-04-16 |
| 1255898979 | Yan K Chan | Custodial Care Facility | 6504 Bay Pkwy, Brooklyn, NY 11204-3931 | 2019-02-28 |
| 1609357284 | Sun Sunshine Adult Daycare Ctr Inc | Custodial Care Facility | 738 58th St, Brooklyn, NY 11220-3917 | 2018-08-22 |
| 1285113548 | The House of Hope | Custodial Care Facility | 31 Standish Rd, Valley Stream, NY 11580-1131 | 2018-08-08 |
| 1083112940 | True Quality Care | Custodial Care Facility | 1616 Chili Ave, Rochester, NY 14624-3246 | 2018-01-25 |
| Find all providers with the same taxonomy | ||||
| City | QUEENS VILLAGE |
| Zip Code | 11429 |
Please comment or provide details below to improve the information on MISS MAXINE ROSEMARIE HARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.