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General NPI Number Information
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NPI Number | 1750563763
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Entity Type | Organization
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Legal Business Name | CARE BY YOUR SIDE
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 123 SOUTH WHITE HORSE PIKE UNIT C
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City | SOMERDALE
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State | NJ
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Zip | 08083-1757
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Country | US
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Telephone | 856-784-4047
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Fax | 856-784-4049
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Provider Business Mailing Address
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Address Line | 123 SPUTH WHITE HORSE PIKE UNIT C
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City | SOMERDALE
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State | NJ
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Zip | 08083-1757
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Country | US
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Telephone | 856-784-4047
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Fax | 856-784-4049
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Authorized Official
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Title or Position | PARTNER
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Name | MRS. MARY TRONGONE
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Credential |
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Telephone | 856-784-4047
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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 | HP0101900
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License Number State | NJ
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