Healthcare Provider Details

I. General information

NPI: 1609010792
Provider Name (Legal Business Name): HOME SWEET HOME ADULT MED. DAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 ROUTE 168 SUITE 100-101
TURNERSVILLE NJ
08012-3215
US

IV. Provider business mailing address

860 ROUTE 168 SUITE 100-101
TURNERSVILLE NJ
08012-3215
US

V. Phone/Fax

Practice location:
  • Phone: 609-220-1184
  • Fax:
Mailing address:
  • Phone: 609-220-1184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. PAULA BOYD
Title or Position: ADMINISTRATOR
Credential:
Phone: 609-220-1184