Provider Demographics
NPI:1699391524
Name:INDEPENDENT CAREGIVERS AGENCY CORP.
Entity Type:Organization
Organization Name:INDEPENDENT CAREGIVERS AGENCY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATERYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARIICHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-477-8440
Mailing Address - Street 1:23 SUNSET TER
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1456
Mailing Address - Country:US
Mailing Address - Phone:908-477-8440
Mailing Address - Fax:
Practice Address - Street 1:1 ROSSMOOR DR STE 104
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1596
Practice Address - Country:US
Practice Address - Phone:800-513-2635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health