Provider Demographics
NPI:1902284748
Name:CONSTELLATION HOME CARE MA LLC
Entity Type:Organization
Organization Name:CONSTELLATION HOME CARE MA LLC
Other - Org Name:CONSTELLATION HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:STEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-705-4805
Mailing Address - Street 1:46 STAUDERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2524
Mailing Address - Country:US
Mailing Address - Phone:516-705-4805
Mailing Address - Fax:516-887-8494
Practice Address - Street 1:180 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3519
Practice Address - Country:US
Practice Address - Phone:978-904-3059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health