Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Home Health |
163WH0200X | |||
Geriatrics |
2251G0304X | 65 | Physical Therapist in Private Practice | |
Home Health |
251E00000X | A4[11] | Home Health Agency | |
Infusion Therapy |
163WI0500X | |||
Massage Therapist |
225700000X | |||
Occupational Therapist |
225X00000X | 67 | Occupational Therapist in Private Practice |
| NPI # | 1245745447 |
||||
| LBN Legal business name | SUPPORTIVE HOME HEALTH CARE LLC | ||||
| Authorized official | MICHAEL MALECKI - (EXECUTIVE DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 12/11/2017 | ||||
| Last updated | 06/27/2023 - About 3 years ago | ||||
| Identifiers |
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