Healthcare Provider Details

I. General information

NPI: 1841318482
Provider Name (Legal Business Name): SWEET HOME ADULT MEDICAL DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E MADISON AVE
CLIFTON NJ
07011-2381
US

IV. Provider business mailing address

45 E MADISON AVE
CLIFTON NJ
07011-2381
US

V. Phone/Fax

Practice location:
  • Phone: 973-478-4200
  • Fax: 973-478-3331
Mailing address:
  • Phone: 973-478-4200
  • Fax: 973-478-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number708115
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROLYN ZAKREVSKY
Title or Position: ADMINISTRATOR
Credential:
Phone: 973-478-4200