MEDICARE: HOME STRETCH CONSULTING, 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
1	251E00000X	Home Health Agency
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1497533715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME STRETCH CONSULTING, LLC

Provider Business Mailing Address
First Line	:	46 MILLS AVE
Second Line	:
City	:	PORT MONMOUTH
State	:	NJ
Zip	:	07758-1127
Country	:	US
Telephone Number	:	347-513-9292
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 MILLS AVE
Second Line	:
City	:	PORT MONMOUTH
State	:	NJ
Zip	:	07758-1127
Country	:	US
Telephone Number	:	347-513-9292
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GEORGE BULGER
Credential	:	DROT, OTR/L
Telephone Number	:	347-513-9292

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	10/19/2023

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