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General NPI Number Information
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NPI Number | 1518634617
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Entity Type | Organization
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Legal Business Name | RESIDENCE CARE SERVICE LLC
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 909 N SALISBURY AVE
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City | SPENCER
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State | NC
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Zip | 28159-1828
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Country | US
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Telephone | 347-546-4877
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 LAKEWOOD RD
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City | TOMS RIVER
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State | NJ
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Zip | 08755
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Country | US
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Telephone | 347-546-4877
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ELIEZER KLEIN
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Credential | LNHA
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Telephone | 347-546-4877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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