=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700707254
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CARE OF NJ LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2026
-----------------------------------------------------
Last Update Date | 07/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 295 ROUTE 70 W STE 6
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08002-3096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-566-6252
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35 SUSAN DR
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08873-2839
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-566-6252
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ALISHER MIRZAEV
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 201-566-6252
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------