Provider Demographics
NPI:1790916948
Name:PREFERRED HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:PREFERRED HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:KLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-822-8480
Mailing Address - Street 1:PO BOX 2105
Mailing Address - Street 2:
Mailing Address - City:VENTNOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08406
Mailing Address - Country:US
Mailing Address - Phone:609-822-8480
Mailing Address - Fax:609-822-8481
Practice Address - Street 1:101 S CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:VENTNOR
Practice Address - State:NJ
Practice Address - Zip Code:08406
Practice Address - Country:US
Practice Address - Phone:609-822-8480
Practice Address - Fax:609-822-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0129700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health