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General NPI Number Information
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NPI Number | 1366919342
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Entity Type | Organization
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Legal Business Name | DRTCRS ENTERPRISES LLC
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 990 CEDAR BRIDGE AVE STE B8
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City | BRICK
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State | NJ
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Zip | 08723-4157
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Country | US
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Telephone | 732-575-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 990 CEDAR BRIDGE AVE STE B8
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City | BRICK
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State | NJ
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Zip | 08723-4157
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Country | US
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Telephone | 732-575-9100
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | TRACY CONNELLY
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Credential |
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Telephone | 732-575-9100
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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 |
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License Number State |
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