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General NPI Number Information
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NPI Number | 1093395725
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Entity Type | Organization
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Legal Business Name | INFINITYLIFE HOME CARE INC
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 18 GREEN ST
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City | NEWARK
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State | NJ
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Zip | 07102-3602
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Country | US
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Telephone | 973-888-9445
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Fax | 212-898-1393
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Provider Business Mailing Address
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Address Line | 201 NORTH 12TH STREET 2ND FLOOR
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City | NEWARK
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State | NJ
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Zip | 07107
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Country | US
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Telephone | 347-383-7704
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Fax | 212-898-1393
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID M MANASHER ESQ
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Credential |
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Telephone | 347-383-7704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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