Healthcare Provider Details

I. General information

NPI: 1518320886
Provider Name (Legal Business Name): HEALING AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2016
Last Update Date: 06/15/2024
Certification Date: 06/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 MAIN ST
LUMBERTON NJ
08048-1125
US

IV. Provider business mailing address

200 WALT WHITMAN AVE UNIT 1022
MOUNT LAUREL NJ
08054-8050
US

V. Phone/Fax

Practice location:
  • Phone: 609-241-9232
  • Fax: 609-216-7447
Mailing address:
  • Phone: 609-241-9232
  • Fax: 609-216-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number26NJ00582400
License Number StateNJ

VIII. Authorized Official

Name: JENEE P SKINNER-HAMLER
Title or Position: FNP-BC
Credential: APRN
Phone: 609-241-9232