Provider Demographics
NPI:1386179075
Name:CREA FINDERS TOTAL CARE LLC
Entity Type:Organization
Organization Name:CREA FINDERS TOTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA,CGMA
Authorized Official - Phone:201-403-9300
Mailing Address - Street 1:611 ROUTE 46 WEST
Mailing Address - Street 2:STE 200
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604
Mailing Address - Country:US
Mailing Address - Phone:201-403-9300
Mailing Address - Fax:201-342-5127
Practice Address - Street 1:171 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-7146
Practice Address - Country:US
Practice Address - Phone:201-342-5122
Practice Address - Fax:201-342-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0181800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0382795Medicaid