Healthcare Provider Details

I. General information

NPI: 1427829134
Provider Name (Legal Business Name): EXOUSIA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 19TH AVE
NEWARK NJ
07103-1418
US

IV. Provider business mailing address

48 19TH AVE
NEWARK NJ
07103-1418
US

V. Phone/Fax

Practice location:
  • Phone: 973-745-8859
  • Fax:
Mailing address:
  • Phone: 862-281-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: QUADIRE NEAL
Title or Position: OWNER
Credential:
Phone: 862-281-2936