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General NPI Number Information
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NPI Number | 1124515085
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Entity Type | Organization
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Legal Business Name | SKYDDACARE, LLC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 4400 ROUTE 9 S STE 1000
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City | FREEHOLD
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State | NJ
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Zip | 07728-1383
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Country | US
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Telephone | 732-409-5126
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 ROUTE 9 S STE 1000
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City | FREEHOLD
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State | NJ
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Zip | 07728-1383
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Country | US
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Telephone | 732-409-5126
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER AND CHAIR OF CLINICAL OP
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Name | DOLORES RICHARDS
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Credential | MBA, BSN, RN, CCM
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Telephone | 732-786-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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