Healthcare Provider Details

I. General information

NPI: 1881162352
Provider Name (Legal Business Name): HMH RESIDENTIAL CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 PARK AVE
PLAINFIELD NJ
07060-3227
US

IV. Provider business mailing address

1340 PARK AVE
PLAINFIELD NJ
07060-3227
US

V. Phone/Fax

Practice location:
  • Phone: 908-754-3100
  • Fax: 732-632-1644
Mailing address:
  • Phone: 908-754-3100
  • Fax: 732-632-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4504305
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MR. JOSEPH M LEMAIRE
Title or Position: PRESIDENT DIVERSIFIED VENTURES
Credential:
Phone: 732-751-7520