Provider Demographics
NPI:1558688622
Name:MAS HOME HEALTH CARE
Entity Type:Organization
Organization Name:MAS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMMONS-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-378-5536
Mailing Address - Street 1:1616 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07063-1214
Mailing Address - Country:US
Mailing Address - Phone:973-378-5536
Mailing Address - Fax:973-378-5546
Practice Address - Street 1:3-5 VOSE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2006
Practice Address - Country:US
Practice Address - Phone:973-378-5536
Practice Address - Fax:973-378-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07951000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health