Healthcare Provider Details

I. General information

NPI: 1447573381
Provider Name (Legal Business Name): SWEET ANGEL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2010
Last Update Date: 03/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

548 PAULISON AVE
PASSAIC NJ
07055-2253
US

IV. Provider business mailing address

548 PAULISON AVE
PASSAIC NJ
07055-2253
US

V. Phone/Fax

Practice location:
  • Phone: 973-472-6944
  • Fax: 973-472-6945
Mailing address:
  • Phone: 973-472-6944
  • Fax: 973-472-6945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: BRUNILDA URENA
Title or Position: PRESIDENT
Credential:
Phone: 973-472-6944