SALEM HOME CARE AGENCY, LLC (NPI# 1265795454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265795454 |
| Entity Type | Organization |
| Organization Name | SALEM HOME CARE AGENCY, LLC |
| Practice Address |
220 Hillside Ave Valley Stream NY 11580-2517 |
| Practice Telephone | 5164761475 |
| Mailing Telephone | 5164519426 |
| Mailing Fax Number | 5168871991 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |
| Authorized Official Name | MRS. MARIE GUSTAVE (CEO) |
| Authorized Official Telephone | 3474714707 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | SALEM HOME CARE AGENCY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | 120124000198 | NY | Nursing & Custodial Care Facilities |
| Street Address |
220 HILLSIDE AVE |
| City | VALLEY STREAM |
| State | NY |
| Zip Code | 11580-2517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033450291 | Klara Gustave | Early Intervention Provider Agency | 220 Hillside Ave, Valley Stream, NY 11580-2517 | 2013-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807276 | Jason Diana Lmsw | Clinic/Center | 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 | 2020-10-09 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1427523869 | Jessica Doyle | Social Worker | 5-11 Pflug Pl, Valley Stream, NY 11580 | 2018-10-12 |
| 1013491026 | Syeda Afshan Firdous | Licensed Practical Nurse | 13 Cleaveland St, Valley Stream, NY 11580 | 2018-09-17 |
| 1700377934 | Jisha Merin Mathew | Nurse Practitioner | 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 | 2018-05-23 |
| 1669970273 | Terrice Bell | Social Worker | 50 W Hawthorne Avenue, Valley Streams, NY 11580 | 2018-01-29 |
| 1659883718 | Rita M. Fowler | Registered Nurse | 33 West Hawthorne Ave. Suite 31, New York Health Care, Valley Stream, NY 11580 | 2017-10-30 |
| 1881104768 | Sharon Stephenson | Peer Specialist | 51 Foster Avenue, North Valley Stream, Valley Stream, NY 11580 | 2017-10-05 |
| 1356850200 | Barry Henderson | Case Manager/Care Coordinator | 23 Marlow Road, Valley Stream, NY 11580 | 2017-09-22 |
| 1922526565 | Aneta Kaczmarski | Physical Therapy Assistant | 299 North Corona Ave, Valley Stream, NY 11580 | 2017-09-05 |
| Find all providers in zip 11580 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215460787 | Loren Kenney | Custodial Care Facility | 464 Remsen Rd, Wading River, NY 11792-1747 | 2017-04-11 |
| 1912383324 | Anne Brunache | Custodial Care Facility | 71 Rockland Ln, Spring Valley, NY 10977-2308 | 2015-08-07 |
| 1346633989 | Nys Doccs | Custodial Care Facility | 11739 State Route 22, Great Meadow Correctional Facility, Comstock, NY 12821-0051 | 2015-03-06 |
| 1497146088 | Creative Adult Daycare Corp | Custodial Care Facility | 508 New York Ave, Huntington, NY 11743-4214 | 2015-02-18 |
| 1932538782 | Sunshine Social Day Care Center Inc | Custodial Care Facility | 4124 Sunrise Hwy, Oakdale, NY 11769-1079 | 2013-11-02 |
| 1174951495 | Ocean Front Day Care LLC | Custodial Care Facility | 11502 Ocean Promenade, Rockaway Park, NY 11694-2412 | 2013-10-23 |
| 1023452141 | Ditmas Park Adult Day Care LLC | Custodial Care Facility | 464 E 22nd St, Brooklyn, NY 11226-6902 | 2013-04-19 |
| 1104260389 | Inspire Social Day Care Center | Custodial Care Facility | 5801 Foster Avenue, Brooklyn, NY 11234 | 2013-04-18 |
| 1619211323 | Amber Health LLC | Custodial Care Facility | 220 Forest Dr, Jericho, NY 11753-2320 | 2012-11-19 |
| 1780941948 | Nursing Facility | Custodial Care Facility | 33 Laforce Street, Rochester, NY 14621 | 2012-04-12 |
| Find all providers with the same taxonomy | ||||
| City | VALLEY STREAM |
| Zip Code | 11580 |
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| 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.