Provider Demographics
NPI:1851770234
Name:MOBILITY SPECIAL HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:MOBILITY SPECIAL HOME CARE SERVICES LLC
Other - Org Name:EXECUTIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF NURSE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABALFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:732-599-9794
Mailing Address - Street 1:P.O. BOX 213
Mailing Address - Street 2:
Mailing Address - City:ADELPHIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07710
Mailing Address - Country:US
Mailing Address - Phone:732-308-1512
Mailing Address - Fax:
Practice Address - Street 1:958 ADELPHIA RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8890
Practice Address - Country:US
Practice Address - Phone:732-308-1512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health