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General NPI Number Information
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NPI Number | 1437461159
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Entity Type | Organization
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Legal Business Name | TOTALIFECARE
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 82 CEDAR LN 176
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City | ROSELLE
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State | NJ
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Zip | 07203
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Country | US
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Telephone | 908-259-5865
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Fax |
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Provider Business Mailing Address
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Address Line | 82 CEDAR LN # 176
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City | ROSELLE
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State | NJ
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Zip | 07203-3059
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Country | US
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Telephone | 908-259-5865
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. YESID ARCHILA
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Credential | MB
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Telephone | 908-220-6342
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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 | HP0141600
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License Number State | NJ
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