=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659242188
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANTOBRE HOME CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2025
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 307 MONTANA TRL
-----------------------------------------------------
City | BROWNS MILLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08015-5701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-971-0451
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 MONTANA TRL
-----------------------------------------------------
City | BROWNS MILLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08015-5701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-971-0451
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. LEWIS OWUSU ANTOBRE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-971-0451
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 385HR2060X
-----------------------------------------------------
Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------