Provider Demographics
NPI:1629478201
Name:360 DEGREE CARE
Entity Type:Organization
Organization Name:360 DEGREE CARE
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-299-4243
Mailing Address - Street 1:45 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3856
Mailing Address - Country:US
Mailing Address - Phone:201-299-4243
Mailing Address - Fax:
Practice Address - Street 1:45 N BROAD ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3856
Practice Address - Country:US
Practice Address - Phone:201-299-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health