Healthcare Provider Details

I. General information

NPI: 1124455746
Provider Name (Legal Business Name): HOME INSTEAD SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEMORIAL DR UNIT 102
WARETOWN NJ
08758-1762
US

IV. Provider business mailing address

1 MEMORIAL DR UNIT 102
WARETOWN NJ
08758-2572
US

V. Phone/Fax

Practice location:
  • Phone: 609-607-1900
  • Fax: 609-607-0682
Mailing address:
  • Phone: 609-607-1900
  • Fax: 609-607-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHPO117800
License Number StateNJ

VIII. Authorized Official

Name: MRS. DEBRA ANN LAVIN
Title or Position: OWNER
Credential: RN
Phone: 609-607-1900