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General NPI Number Information
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NPI Number | 1407357379
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Entity Type | Organization
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Legal Business Name | CONLIFFE HOME CARE LLC DBA EXECUTIVE CARE
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Dates
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Enumeration Date | 02/26/2018
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Last Update Date | 02/26/2018
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Provider Practice Location Address
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Address Line | 1807 SPRINGDALE RD STE C
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City | CHERRY HILL
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State | NJ
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Zip | 08003-6000
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Country | US
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Telephone | 856-424-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1807 SPRINGDALE RD STE C
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City | CHERRY HILL
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State | NJ
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Zip | 08003-6000
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Country | US
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Telephone | 856-424-5555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KARA CONLIFFE
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Credential | MD
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Telephone | 856-424-5555
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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 | HP1099600
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License Number State | NJ
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