Healthcare Provider Details

I. General information

NPI: 1366912685
Provider Name (Legal Business Name): ALPHA CARE HOME HEALTH SERVICES OF NJ, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 06/16/2021
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MAIN ST
HACKENSACK NJ
07601-7126
US

IV. Provider business mailing address

95 MAIN ST HACKENSACK NJ 07601
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 973-357-0077
  • Fax: 973-357-4777
Mailing address:
  • Phone: 973-357-0077
  • Fax: 973-357-4777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0663697
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MS. SVETLANA FALIKMAN
Title or Position: PRESIDENT
Credential:
Phone: 973-357-0077