Provider Demographics
NPI:1417410291
Name:FRIENDLY HOME CARE LLC
Entity Type:Organization
Organization Name:FRIENDLY HOME CARE 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:201-798-7600
Mailing Address - Street 1:333 N BROAD ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3706
Mailing Address - Country:US
Mailing Address - Phone:732-203-5700
Mailing Address - Fax:732-326-2993
Practice Address - Street 1:333 N BROAD ST STE 2A
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3706
Practice Address - Country:US
Practice Address - Phone:732-203-5700
Practice Address - Fax:732-326-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health