Provider Demographics
NPI:1629405378
Name:VA HOMECARE LLC
Entity Type:Organization
Organization Name:VA HOMECARE LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-671-2899
Mailing Address - Street 1:253 MAIN ST # 175
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3222
Mailing Address - Country:US
Mailing Address - Phone:732-671-2899
Mailing Address - Fax:732-671-3394
Practice Address - Street 1:394 MONMOUTH AVE
Practice Address - Street 2:
Practice Address - City:LEONARDO
Practice Address - State:NJ
Practice Address - Zip Code:07737-1130
Practice Address - Country:US
Practice Address - Phone:732-671-2899
Practice Address - Fax:732-671-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0077900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health