Healthcare Provider Details

I. General information

NPI: 1306133277
Provider Name (Legal Business Name): CARING HOME THERAPY SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 ANDOVER RD
SPARTA NJ
07871-1003
US

IV. Provider business mailing address

154 ANDOVER RD
SPARTA NJ
07871-1003
US

V. Phone/Fax

Practice location:
  • Phone: 862-812-6433
  • Fax:
Mailing address:
  • Phone: 862-812-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number40QA01192100
License Number StateNJ

VIII. Authorized Official

Name: MRS. LESLY Y ALBUQUERQUE
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT
Phone: 862-812-6433