Healthcare Provider Details
I. General information
NPI: 1144845983
Provider Name (Legal Business Name): INMERCY HOME CARE SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2020
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
396 15TH AVE
NEWARK NJ
07103-2326
US
IV. Provider business mailing address
396 15TH AVE
NEWARK NJ
07103-2326
US
V. Phone/Fax
- Phone: 973-622-0700
- Fax: 973-622-0711
- Phone: 973-622-0700
- Fax: 973-622-0711
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2050X |
| Taxonomy | Respite Care Camp |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERICA
A
JAMES
Title or Position: OFFICE MANAGER
Credential: MBA
Phone: 908-937-0142