NPIMap

Organization Active NPI

Modern Life Home Care, LLC

  • In Home Supportive Care Agency
  • New York, NY
National Provider Identifier
1154854768
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
MODERN LIFE HOME CARE, LLC
Practice address
17 State St
Suite 4000
New York, NY 10004-1501
Phone
(212) 328-2078
NPI assigned
Apr 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tracey Delmar Hennix Charles, RN
Title
Owner
Phone
(212) 328-2078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

17 State St
Suite 4000
New York, NY 10004-1501

Mailing address

17 State St
Suite 4000
New York, NY 10004-1501
Phone (212) 328-2078

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1154854768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STATE ST",
            "address_2": "SUITE 4000",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041501",
            "telephone_number": "212-328-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STATE ST",
            "address_2": "SUITE 4000",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041501",
            "telephone_number": "212-328-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN LIFE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "HENNIX CHARLES",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "DELMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-328-2078",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.