MEDICARE: SIRECARE HOME ASSIST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1487517108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIRECARE HOME ASSIST LLC

Provider Business Mailing Address
First Line	:	705 DODD LN
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30518-6443
Country	:	US
Telephone Number	:	908-416-2128
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 MOUNT VERNON PL APT 9A
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07106-3136
Country	:	US
Telephone Number	:	908-416-2128
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OSARIEME V LEBARTY
Credential	:
Telephone Number	:	908-416-2128

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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