Healthcare Provider Details

I. General information

NPI: 1649506007
Provider Name (Legal Business Name): RELIABLE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 COOPER ST
WOODBURY NJ
08096-4650
US

IV. Provider business mailing address

57 COOPER ST
WOODBURY NJ
08096-4650
US

V. Phone/Fax

Practice location:
  • Phone: 856-384-9433
  • Fax: 856-384-9435
Mailing address:
  • Phone: 856-384-9433
  • Fax: 856-384-9435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHP0086200
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIENNE DAUTRUCHE
Title or Position: PRESIDENT/OWNER
Credential: RN, BSN
Phone: 856-384-9433