Provider Demographics
NPI:1912578972
Name:MARANATHA HOME CARE INC
Entity Type:Organization
Organization Name:MARANATHA HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTZLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-7722
Mailing Address - Street 1:1 N LEXINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1736
Mailing Address - Country:US
Mailing Address - Phone:914-467-5529
Mailing Address - Fax:
Practice Address - Street 1:4880 DONALD ROSS RD.
Practice Address - Street 2:SUITE 200
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33418
Practice Address - Country:US
Practice Address - Phone:914-428-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health