Healthcare Provider Details

I. General information

NPI: 1487519658
Provider Name (Legal Business Name): ELDERLY CARE COMPANION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W PALISADE AVE STE C
ENGLEWOOD NJ
07631-2629
US

IV. Provider business mailing address

101 W PALISADE AVE STE C
ENGLEWOOD NJ
07631-2629
US

V. Phone/Fax

Practice location:
  • Phone: 917-420-1774
  • Fax:
Mailing address:
  • Phone: 917-420-1774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ROSANNA ROGERS
Title or Position: OWNER
Credential:
Phone: 917-420-1774