Provider Demographics
NPI:1932513538
Name:PATRIOT ELDER CARE
Entity Type:Organization
Organization Name:PATRIOT ELDER CARE
Other - Org Name:ADULT DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:201-880-7755
Mailing Address - Street 1:15 5TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-6100
Mailing Address - Country:US
Mailing Address - Phone:201-880-7755
Mailing Address - Fax:201-880-7756
Practice Address - Street 1:15 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6100
Practice Address - Country:US
Practice Address - Phone:201-880-7755
Practice Address - Fax:201-880-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services