Provider Demographics
NPI:1669509667
Name:BACK HOME SAFELY
Entity Type:Organization
Organization Name:BACK HOME SAFELY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:973-219-4147
Mailing Address - Street 1:5 TANGLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4306
Mailing Address - Country:US
Mailing Address - Phone:973-366-3988
Mailing Address - Fax:
Practice Address - Street 1:5 TANGLEWOOD CT
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4306
Practice Address - Country:US
Practice Address - Phone:973-366-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00181500332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment