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General NPI Number Information
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NPI Number | 1083149975
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Entity Type | Organization
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Legal Business Name | MOM AND PAP'S HOME CARE AGENCY, LLC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 50 E PALISADE AVE 2ND FLOOR SUITE 206
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2933
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Country | US
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Telephone | 201-567-3181
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Fax | 201-567-1122
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Provider Business Mailing Address
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Address Line | 50 E PALISADE AVE 2ND FLOOR SUITE 206
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2933
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Country | US
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Telephone | 201-567-3181
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Fax | 201-567-1122
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Authorized Official
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Title or Position | CEO
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Name | ENA E FORBES
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Credential | PRESIDENT
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Telephone | 201-567-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HP0256500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HP0256500
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License Number State | NJ
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