Provider Demographics
NPI:1528190949
Name:HOME CARE 24-7, A SUPPORTIVE LIVING PC
Entity Type:Organization
Organization Name:HOME CARE 24-7, A SUPPORTIVE LIVING PC
Other - Org Name:HOME CARE 24-7
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MINICUCCCI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:201-291-0101
Mailing Address - Street 1:218 STATE RT 17 N
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3399
Mailing Address - Country:US
Mailing Address - Phone:201-291-0101
Mailing Address - Fax:
Practice Address - Street 1:218 STATE RT 17 N
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3399
Practice Address - Country:US
Practice Address - Phone:201-291-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0086000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health