Healthcare Provider Details

I. General information

NPI: 1669337895
Provider Name (Legal Business Name): FIRST LIGHT HOME CARE OF GLOUCESTER TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 WHITE HORSE RD # 204
VOORHEES NJ
08043-4405
US

IV. Provider business mailing address

1099 WHITE HORSE RD # 204
VOORHEES NJ
08043-4405
US

V. Phone/Fax

Practice location:
  • Phone: 609-790-0693
  • Fax:
Mailing address:
  • Phone: 609-790-0693
  • Fax:

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: PASQUALE DEMITRIO
Title or Position: ADMINISTRATOR
Credential:
Phone: 609-790-0693