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NPI Code Detail

MEDICARE: FUN FUNCTION HOME CARE LLC

MEDICARE: FUN FUNCTION HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1104633205
Entity Type Code : Organization
Provider Name (Legal Business Name) : FUN FUNCTION HOME CARE LLC
Provider Business Mailing Address
First Line : 165 PASSAIC AVE STE 205
Second Line :
City : FAIRFIELD
State : NJ
Zip : 07004-3526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 165 PASSAIC AVE STE 205
Second Line :
City : FAIRFIELD
State : NJ
Zip : 07004-3526
Country : US
Telephone Number : 929-722-1297
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SABRINA SOTO
Credential :
Telephone Number : 929-722-1297
Provider Enumeration Date : 12/12/2024
Last Update Date : 12/12/2024

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Directions to “FUN FUNCTION HOME CARE LLC ” Practice Location

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