Healthcare Provider Details

I. General information

NPI: 1457504219
Provider Name (Legal Business Name): LPM HOMCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 GARDEN ST
MOUNT HOLLY NJ
08060-1839
US

IV. Provider business mailing address

9 GARDEN ST
MOUNT HOLLY NJ
08060-1839
US

V. Phone/Fax

Practice location:
  • Phone: 173-265-7360
  • Fax: 173-265-7360
Mailing address:
  • Phone: 173-265-7360
  • Fax: 173-265-7360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberHPO105400
License Number StateNJ

VIII. Authorized Official

Name: MS. MARIA PORCHIA
Title or Position: CEO
Credential: RN
Phone: 16092612995