Provider Demographics
NPI:1689292336
Name:365 HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:365 HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-450-0742
Mailing Address - Street 1:405 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-2813
Mailing Address - Country:US
Mailing Address - Phone:917-200-2719
Mailing Address - Fax:
Practice Address - Street 1:405 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-2813
Practice Address - Country:US
Practice Address - Phone:917-200-2719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health