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General NPI Number Information
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NPI Number | 1902946304
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Entity Type | Organization
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Legal Business Name | IDAM HOME CARE SERVICES
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 2572 S BROAD ST
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City | HAMILTON
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State | NJ
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Zip | 08610-4018
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Country | US
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Telephone | 609-888-4844
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Fax | 609-888-3443
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Provider Business Mailing Address
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Address Line | 2572 S BROAD ST
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City | HAMILTON
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State | NJ
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Zip | 08610-4018
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Country | US
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Telephone | 609-888-4844
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Fax | 609-888-3443
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. IAN GRIFFITHS
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Credential |
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Telephone | 609-888-4844
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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 | HP0022100
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License Number State | NJ
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