Healthcare Provider Details

I. General information

NPI: 1376247718
Provider Name (Legal Business Name): ATLAS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 VAN BUREN STREET 2ND FLOOR
NEWARK NJ
07105-6913
US

IV. Provider business mailing address

132 VAN BUREN ST STE 2
NEWARK NJ
07105-6913
US

V. Phone/Fax

Practice location:
  • Phone: 732-808-0400
  • Fax: 732-808-0401
Mailing address:
  • Phone: 732-808-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: SHANI MADAMINOVA
Title or Position: ADMINISTRATOR
Credential:
Phone: 732-808-0400