Provider Demographics
NPI:1477048197
Name:CITADEL HOME CARE LLC
Entity Type:Organization
Organization Name:CITADEL HOME CARE LLC
Other - Org Name:WATER STREET CAPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGLOIRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:862-881-2331
Mailing Address - Street 1:589 MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1215
Mailing Address - Country:US
Mailing Address - Phone:862-881-2331
Mailing Address - Fax:800-540-5946
Practice Address - Street 1:60 COLONIAL TER
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2123
Practice Address - Country:US
Practice Address - Phone:800-589-4161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home