Healthcare Provider Details

I. General information

NPI: 1548769326
Provider Name (Legal Business Name): PREMIER CARE LLC DBA ELDER LIFE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 ROUTE 66 E STE 225
TINTON FALLS NJ
07753
US

IV. Provider business mailing address

ONE HOVCHILD BLVD. 4000 ROUTE 66 SUITE 225
TINTON FALLS NJ
07753
US

V. Phone/Fax

Practice location:
  • Phone: 732-493-8080
  • Fax:
Mailing address:
  • Phone: 732-493-8080
  • Fax: 732-493-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JUDITH S PARNES
Title or Position: EXECUTIVE DIRECTOR
Credential: ACSW, LCSW, CMC
Phone: 732-493-8080