Provider Demographics
NPI:1831264001
Name:SELFHELP COMMUNITY SERVICES HOME ATTENDANT CORPORATION
Entity type:Organization
Organization Name:SELFHELP COMMUNITY SERVICES HOME ATTENDANT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. VP, OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:212-971-7664
Mailing Address - Street 1:520 8TH AVE.
Mailing Address - Street 2:5 TH FLOOR
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6553
Mailing Address - Country:US
Mailing Address - Phone:212-971-7600
Mailing Address - Fax:212-629-9482
Practice Address - Street 1:520 8TH AVE.
Practice Address - Street 2:5 TH FLOOR
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10018-6553
Practice Address - Country:US
Practice Address - Phone:212-971-7600
Practice Address - Fax:212-629-9482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0868L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00922216Medicaid
NY00912348Medicaid