Healthcare Provider Details

I. General information

NPI: 1922246438
Provider Name (Legal Business Name): NEW JERSEY CUIDADO CASERO HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W LANDIS AVE STE 100
VINELAND NJ
08360-8124
US

IV. Provider business mailing address

415 W LANDIS AVE STE 100
VINELAND NJ
08360-8124
US

V. Phone/Fax

Practice location:
  • Phone: 856-696-5340
  • Fax: 856-696-5310
Mailing address:
  • Phone: 856-696-5340
  • Fax: 856-696-5310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number24111
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE MARTINELLI
Title or Position: ADMINISTRATOR
Credential:
Phone: 856-696-5340