Provider Demographics
NPI:1114401593
Name:COLLEGE AVENUE PARTNERS LLC
Entity Type:Organization
Organization Name:COLLEGE AVENUE PARTNERS LLC
Other - Org Name:VISITING ANGELS OF MATAWAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-671-2899
Mailing Address - Street 1:5 RAVINE DR FL 2
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3106
Mailing Address - Country:US
Mailing Address - Phone:732-671-2899
Mailing Address - Fax:
Practice Address - Street 1:5 RAVINE DR FL 2
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3106
Practice Address - Country:US
Practice Address - Phone:732-671-2899
Practice Address - Fax:732-671-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health