Provider Demographics
NPI:1114422862
Name:ELDERLY HEALTHCARE CONSULTING
Entity Type:Organization
Organization Name:ELDERLY HEALTHCARE CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAKEESA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-986-4582
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-0685
Mailing Address - Country:US
Mailing Address - Phone:856-986-4582
Mailing Address - Fax:
Practice Address - Street 1:33 DECATUR LN
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2806
Practice Address - Country:US
Practice Address - Phone:856-986-4582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251B00000X, 251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage