Provider Demographics
NPI:1265832638
Name:ATLANTIC HOME CARE, LLC
Entity Type:Organization
Organization Name:ATLANTIC HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL/MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSHNIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-444-9900
Mailing Address - Street 1:22 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1410
Mailing Address - Country:US
Mailing Address - Phone:848-444-9900
Mailing Address - Fax:444-848-9901
Practice Address - Street 1:22 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1410
Practice Address - Country:US
Practice Address - Phone:444-848-9900
Practice Address - Fax:848-444-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP01779900251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health