Healthcare Provider Details

I. General information

NPI: 1568307718
Provider Name (Legal Business Name): 360 CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W PALISADE AVE
ENGLEWOOD NJ
07631-2706
US

IV. Provider business mailing address

61 W PALISADE AVE
ENGLEWOOD NJ
07631-2706
US

V. Phone/Fax

Practice location:
  • Phone: 908-601-2787
  • Fax:
Mailing address:
  • Phone: 908-601-2787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY SAMANDAROV
Title or Position: CEO
Credential:
Phone: 908-601-2787