Provider Demographics
NPI:1376247718
Name:ATLAS HOMECARE LLC
Entity Type:Organization
Organization Name:ATLAS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAMINOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-354-8100
Mailing Address - Street 1:132 VAN BUREN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-6913
Mailing Address - Country:US
Mailing Address - Phone:973-354-8100
Mailing Address - Fax:
Practice Address - Street 1:132 VAN BUREN ST STE 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-6913
Practice Address - Country:US
Practice Address - Phone:973-354-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health