Healthcare Provider Details

I. General information

NPI: 1083461255
Provider Name (Legal Business Name): WELLNESS-AT-HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 05/04/2024
Certification Date: 05/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 STATE ROUTE 35 STE 205E
OAKHURST NJ
07755-2759
US

IV. Provider business mailing address

1806 STATE ROUTE 35 STE 205E
OAKHURST NJ
07755-2759
US

V. Phone/Fax

Practice location:
  • Phone: 732-687-6129
  • Fax:
Mailing address:
  • Phone: 732-687-6129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARJORIE PIERRE JEROME
Title or Position: DON/SUPERVISOR
Credential: RN, MSN
Phone: 732-687-6129