Provider Demographics
NPI:1922246438
Name:NEW JERSEY CUIDADO CASERO HOSPICE LLC
Entity Type:Organization
Organization Name:NEW JERSEY CUIDADO CASERO HOSPICE LLC
Other - Org Name:NJ HEALTH HOSPICE AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-696-5340
Mailing Address - Street 1:415 W LANDIS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8124
Mailing Address - Country:US
Mailing Address - Phone:856-696-5340
Mailing Address - Fax:856-696-5310
Practice Address - Street 1:415 W LANDIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8124
Practice Address - Country:US
Practice Address - Phone:856-696-5340
Practice Address - Fax:856-696-5310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24111251G00000X
363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0348562Medicaid