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HOMETOWN HEALTHCARE PORT JERVIS FAMILY HEALTH NURSE PRACTITIONER PLLC

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Company Details

Name: HOMETOWN HEALTHCARE PORT JERVIS FAMILY HEALTH NURSE PRACTITIONER PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 10 Oct 2024 (9 months ago)
Entity Number: 7441946
ZIP code: 12771
County: Orange
Place of Formation: New York
Address: 32 BALL STREET, PORT JERVIS, NY, United States, 12771

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 32 BALL STREET, PORT JERVIS, NY, United States, 12771

National Provider Identifier

NPI Number:
1477399871
Certification Date:
2024-11-19

Authorized Person:

Name:
ROSELLE AGUILA LITTLE
Role:
MANAGING DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
9183988354
Fax:
9183989354

Filings

Filing Number Date Filed Type Effective Date
241015001305 2024-10-10 ARTICLES OF ORGANIZATION 2024-10-10

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State