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General NPI Number Information
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NPI Number | 1790916948
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Entity Type | Organization
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Legal Business Name | PREFERRED HOME CARE AGENCY, INC.
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 101 S CAMBRIDGE AVE
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-822-8480
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Fax | 609-822-8481
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Provider Business Mailing Address
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Address Line | PO BOX 2105
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-822-8480
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Fax | 609-822-8481
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Authorized Official
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Title or Position | OWNER/SECRETARY
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Name | MRS. KLARA VAYSBERG
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Credential |
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Telephone | 609-822-8480
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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 | HP0129700
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License Number State | NJ
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