Provider Demographics
NPI:1689372666
Name:AT HOME CARE OF NEW JERSEY
Entity Type:Organization
Organization Name:AT HOME CARE OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:973-384-9545
Mailing Address - Street 1:277 FAIRFIELD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1931
Mailing Address - Country:US
Mailing Address - Phone:973-384-9545
Mailing Address - Fax:973-653-0999
Practice Address - Street 1:277 FAIRFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1931
Practice Address - Country:US
Practice Address - Phone:973-384-9545
Practice Address - Fax:973-653-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care