Healthcare Provider Details

I. General information

NPI: 1548032915
Provider Name (Legal Business Name): DAHLIAS HOME CARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 JOHN ST STE 108
FORT LEE NJ
07024-2577
US

IV. Provider business mailing address

1605 JOHN ST STE 108
FORT LEE NJ
07024-2577
US

V. Phone/Fax

Practice location:
  • Phone: 844-634-6500
  • Fax: 844-874-5724
Mailing address:
  • Phone: 844-634-6500
  • Fax: 844-874-5724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAHLIA PURVEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 844-634-6500