Provider Demographics
NPI:1730314055
Name:HOME SWEET HOME PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HOME SWEET HOME PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANFREDONIA
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:908-331-1654
Mailing Address - Street 1:162 JOYSAN TER
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9304
Mailing Address - Country:US
Mailing Address - Phone:908-331-1654
Mailing Address - Fax:732-359-1567
Practice Address - Street 1:162 JOYSAN TER
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9304
Practice Address - Country:US
Practice Address - Phone:908-331-1654
Practice Address - Fax:732-359-1567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-17
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00868400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy