Healthcare Provider Details

I. General information

NPI: 1679067433
Provider Name (Legal Business Name): PARKER HOME AND COMMUNITY BASED SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OVERLOOK DR
MONROE TOWNSHIP NJ
08831-5532
US

IV. Provider business mailing address

443 RIVER RD
HIGHLAND PARK NJ
08904-1914
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-6853
  • Fax:
Mailing address:
  • Phone: 732-418-8615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number83001
License Number StateNJ

VIII. Authorized Official

Name: MRS. MEGAN CHRISTINA KOVALTCHOUK
Title or Position: SENIOR DIRECTOR HCBS
Credential:
Phone: 732-418-8615