Healthcare Provider Details

I. General information

NPI: 1740678861
Provider Name (Legal Business Name): FREEHOLD HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROADWAY SUITE 601
PATERSON NJ
07514-1524
US

IV. Provider business mailing address

40 VREELAND AVE SUITE 107
TOTOWA NJ
07512-1159
US

V. Phone/Fax

Practice location:
  • Phone: 973-812-9777
  • Fax: 973-812-0518
Mailing address:
  • Phone: 973-812-9777
  • Fax: 973-812-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. ROBERT FRANK NOTTE
Title or Position: MANAGING MEMBER
Credential:
Phone: 973-812-9777