Healthcare Provider Details

I. General information

NPI: 1710218391
Provider Name (Legal Business Name): PROVIDERS OF CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 DREXEL CT
SICKLERVILLE NJ
08081-2801
US

IV. Provider business mailing address

11 DREXEL CT
SICKLERVILLE NJ
08081-2801
US

V. Phone/Fax

Practice location:
  • Phone: 856-262-2606
  • Fax: 856-404-9253
Mailing address:
  • Phone: 856-262-2605
  • Fax: 856-404-9253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK MAY
Title or Position: PRESIDENT
Credential:
Phone: 856-262-2605