Provider Demographics
NPI:1700389103
Name:CAREBRIDGE HOME CARE, LLC
Entity Type:Organization
Organization Name:CAREBRIDGE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BONAVITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-722-7800
Mailing Address - Street 1:701 BROOKLYN BLVD
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1400
Mailing Address - Country:US
Mailing Address - Phone:732-722-7800
Mailing Address - Fax:732-722-7799
Practice Address - Street 1:701 BROOKLYN BLVD
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1400
Practice Address - Country:US
Practice Address - Phone:732-722-7800
Practice Address - Fax:732-722-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0148000374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0148000OtherHEALTH CARE SERVICE FIRM