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General NPI Number Information
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NPI Number | 1528342896
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Entity Type | Organization
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Legal Business Name | GRACE JEAN, LLC DBA SYNERGY HOMECARE
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 212 BELLEVUE AVE FL 2
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City | HAMMONTON
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State | NJ
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Zip | 08037-1722
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Country | US
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Telephone | 609-561-4306
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Fax | 866-884-0430
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Provider Business Mailing Address
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Address Line | 212 BELLEVUE AVE FL 2
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City | HAMMONTON
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State | NJ
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Zip | 08037-1722
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Country | US
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Telephone | 609-561-4306
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Fax | 866-884-0430
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Authorized Official
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Title or Position | OWNER
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Name | JEANNE CHIARADIO
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Credential |
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Telephone | 609-561-4306
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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 | HP0133200
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License Number State | NJ
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