Active NPI
Lutheran Center at Poughkeepsie, Inc
- Home Health Agency
- Hauppauge, NY
National Provider Identifier
1750454567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 5157905L
- Legal business name
- LUTHERAN CENTER AT POUGHKEEPSIE, INC
- Practice address
- 390 Rabro Dr
Suite B
Hauppauge, NY 11788-4244 - Phone
- (631) 761-5444
- Fax
- (631) 761-5445
- NPI assigned
- Nov 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Susan Cadoff, RN
- Title
- VP Home Care & Community Services
- Phone
- (914) 365-6365
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 5157905L | NY | Primary |
Addresses
Primary practice location
390 Rabro Dr
Suite B
Hauppauge, NY 11788-4244
Mailing address
390 Rabro Dr
Suite B
Hauppauge, NY 11788-4244
Phone (631) 761-5444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00793788 | Medicaid | NY |
Other names 1
- Lutheran Long Term Home Health Care Program
National Provider Directory
National Provider DirectoryLocations
390 Rabro Dr
Ste B
Hauppauge, NY 11788
Phone (631) 761-5444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1378771200000",
"number": "1750454567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 RABRO DR",
"address_2": "SUITE B",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884244",
"telephone_number": "631-761-5444",
"fax_number": "631-761-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 RABRO DR",
"address_2": "SUITE B",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117884244",
"telephone_number": "631-761-5444",
"fax_number": "631-761-5445"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUTHERAN CENTER AT POUGHKEEPSIE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2013-09-10",
"status": "A",
"authorized_official_last_name": "CADOFF",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "VP HOME CARE & COMMUNITY SERVICES",
"authorized_official_telephone_number": "914-365-6365",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NY",
"license": "5157905L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00793788",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lutheran Long Term Home Health Care Program",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.