Healthcare Provider Details

I. General information

NPI: 1649259292
Provider Name (Legal Business Name): SALEM HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SALEM WOODSTOWN RD 2ND FLOOR, 2 EAST
SALEM NJ
08079-2064
US

IV. Provider business mailing address

310 SALEM WOODSTOWN RD 2ND FLOOR, 2 EAST
SALEM NJ
08079-2064
US

V. Phone/Fax

Practice location:
  • Phone: 856-678-8500
  • Fax: 856-678-5180
Mailing address:
  • Phone: 856-678-8500
  • Fax: 856-678-5180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number22761
License Number StateNJ

VIII. Authorized Official

Name: MS. LAURIE HOLTSFORD
Title or Position: SR.DIRECTOR BUSINESS OFFICE SUPPORT
Credential:
Phone: 615-465-7466