MEDICARE: ANTOBRE HOME CARE SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
4	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1659242188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTOBRE HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	307 MONTANA TRL
Second Line	:
City	:	BROWNS MILLS
State	:	NJ
Zip	:	08015-5701
Country	:	US
Telephone Number	:	917-971-0451
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 MONTANA TRL
Second Line	:
City	:	BROWNS MILLS
State	:	NJ
Zip	:	08015-5701
Country	:	US
Telephone Number	:	917-971-0451
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. LEWIS OWUSU ANTOBRE
Credential	:
Telephone Number	:	917-971-0451

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

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