Healthcare Provider Details

I. General information

NPI: 1174205892
Provider Name (Legal Business Name): AGAPE TOUCH LLC DBA PREFERRED CARE AT HOME OF NORTHEAST NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MAIN ST
MILLBURN NJ
07041-1362
US

IV. Provider business mailing address

109 MAIN ST
MILLBURN NJ
07041-1362
US

V. Phone/Fax

Practice location:
  • Phone: 973-783-4663
  • Fax: 973-814-9820
Mailing address:
  • Phone: 973-783-4663
  • Fax: 973-814-9820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERICA RATTTRAY-ST JEAN
Title or Position: CO-OWNER/CEO
Credential:
Phone: 973-943-3646