Healthcare Provider Details

I. General information

NPI: 1477016681
Provider Name (Legal Business Name): PARR ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2019
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 STULTS RD STE 125
DAYTON NJ
08810-2514
US

IV. Provider business mailing address

12 STULTS RD STE 125
DAYTON NJ
08810-1646
US

V. Phone/Fax

Practice location:
  • Phone: 732-690-5801
  • Fax:
Mailing address:
  • Phone: 732-690-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: SESH SUBRAMANIAN
Title or Position: MANAGING OWNER
Credential:
Phone: 732-690-5801