Provider Demographics
NPI:1629078308
Name:COMPREHENSIVE HOME CARE SERVICES OF NJ
Entity Type:Organization
Organization Name:COMPREHENSIVE HOME CARE SERVICES OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:MATZKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-378-3333
Mailing Address - Street 1:12 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1773
Mailing Address - Country:US
Mailing Address - Phone:973-763-7665
Mailing Address - Fax:
Practice Address - Street 1:12 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1773
Practice Address - Country:US
Practice Address - Phone:973-763-7665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0096700251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112686OtherAETNA
NJA637645OtherOXFORD CONTRACT NUMBER
NJ5429005Medicaid