Provider Demographics
NPI:1639208119
Name:CHRILL CARE, INC
Entity Type:Organization
Organization Name:CHRILL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPALDI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:973-744-8103
Mailing Address - Street 1:201 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2714
Mailing Address - Country:US
Mailing Address - Phone:973-744-8103
Mailing Address - Fax:973-744-6950
Practice Address - Street 1:201 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2714
Practice Address - Country:US
Practice Address - Phone:973-744-8103
Practice Address - Fax:973-744-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO115500374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00827708Medicaid