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General NPI Number Information
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NPI Number | 1205310018
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Entity Type | Organization
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Legal Business Name | CITADEL AT HOME LLC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 7 GLENWOOD AVE STE 412
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City | EAST ORANGE
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State | NJ
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Zip | 07017-1041
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Country | US
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Telephone | 973-965-0366
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Fax | 973-965-0367
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Provider Business Mailing Address
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Address Line | 1000 GATES AVE STE 4
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City | BROOKLYN
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State | NY
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Zip | 11221-6296
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Country | US
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Telephone | 917-805-0702
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Fax | 718-280-1050
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | GREGORY THOMAS CRAWFORD
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Credential |
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Telephone | 973-965-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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