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General NPI Number Information
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NPI Number | 1295981223
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Entity Type | Organization
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Legal Business Name | ASSISTED INDEPENDENCE SERVICES, INC,
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 3455 STATE ROUTE 66 SUITE 3
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City | NEPTUNE
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State | NJ
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Zip | 07753-2758
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Country | US
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Telephone | 732-922-4100
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Fax | 732-210-0366
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Provider Business Mailing Address
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Address Line | 3455 STATE ROUTE 66 SUITE 3
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City | NEPTUNE
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State | NJ
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Zip | 07753-2758
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Country | US
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Telephone | 732-922-4100
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Fax | 732-210-0366
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS E DAUGHERTY
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Credential |
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Telephone | 732-922-4100
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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 | HP0090900
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License Number State | NJ
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