Provider Demographics
NPI:1376556704
Name:EMBRACING HOSPICECARE OF NEW JERSEY WEST, LLC
Entity Type:Organization
Organization Name:EMBRACING HOSPICECARE OF NEW JERSEY WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TANGOLICS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-974-2545
Mailing Address - Street 1:2101 STATE ROUTE 34
Mailing Address - Street 2:SUITE B
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9104
Mailing Address - Country:US
Mailing Address - Phone:732-974-2545
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:SUITE 23
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3174
Practice Address - Country:US
Practice Address - Phone:609-662-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24072251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based