Healthcare Provider Details

I. General information

NPI: 1104523265
Provider Name (Legal Business Name): AMOR HOMECARE OF NJ INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 MOUNTAIN VIEW RD
ENGLEWOOD NJ
07631-1617
US

IV. Provider business mailing address

11027 106TH ST
OZONE PARK NY
11417-2614
US

V. Phone/Fax

Practice location:
  • Phone: 917-226-0509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: AGUSTIN PRADO
Title or Position: CMO
Credential:
Phone: 917-226-0509