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General NPI Number Information
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NPI Number | 1932513538
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Entity Type | Organization
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Legal Business Name | PATRIOT ELDER CARE
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 15 5TH ST SUITE 101
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-6100
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Country | US
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Telephone | 201-880-7755
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Fax | 201-880-7756
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Provider Business Mailing Address
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Address Line | 15 5TH ST SUITE 101
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-6100
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Country | US
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Telephone | 201-880-7755
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Fax | 201-880-7756
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Authorized Official
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Title or Position | OPERATOR/OWNER
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Name | CELESTE ANN HAMPTON
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Credential | LPN
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Telephone | 201-880-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NJ
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