Doctor Name: | MISS MAXINE ROSEMARIE HARRIS |
NPI Number: | 1023377611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 460234-1 |
Business Practice Address: | 220-08 109 Avenue Queens Village, NY - 11429 |
Business Phone Number: | 9172267249 |
Business Fax Number: | |
Mailing Address: | 22008 109th Ave, QUEENS VILLAGE |
State: | NY |
Postal Code: | 114292515 |
Phone Number: | 9172267249 |
Fax Number: | |
NPI Enumeration Date: | 05/16/2012 |
NPI Last Update Date: | 05/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | 460234-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |