Provider Demographics
NPI:1154055879
Name:AUTHENTIC CARE
Entity Type:Organization
Organization Name:AUTHENTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBA PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-857-2296
Mailing Address - Street 1:6135 BERGENLINE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1562
Mailing Address - Country:US
Mailing Address - Phone:609-807-2293
Mailing Address - Fax:609-857-2295
Practice Address - Street 1:6135 BERGENLINE AVE STE 4
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1562
Practice Address - Country:US
Practice Address - Phone:609-807-2293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty