Provider Demographics
NPI:1801970629
Name:RAPHA NURSING AGENCY INC.
Entity type:Organization
Organization Name:RAPHA NURSING AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:H
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:718-479-3452
Mailing Address - Street 1:19930 HOLLIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1232
Mailing Address - Country:US
Mailing Address - Phone:718-479-3452
Mailing Address - Fax:718-776-0708
Practice Address - Street 1:19930 HOLLIS AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1232
Practice Address - Country:US
Practice Address - Phone:718-479-3452
Practice Address - Fax:718-776-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1233532251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care