Healthcare Provider Details

I. General information

NPI: 1467874438
Provider Name (Legal Business Name): HOME SWEET HOME OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N BROAD ST
ELIZABETH NJ
07208-3302
US

IV. Provider business mailing address

717 BROADWAY
NEWARK NJ
07104-3401
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-0050
  • Fax:
Mailing address:
  • Phone: 973-268-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number908116
License Number StateNJ

VIII. Authorized Official

Name: MR. ALBERT ROSENBERG
Title or Position: MEMBER
Credential:
Phone: 973-268-1212