Provider Demographics
NPI:1952070062
Name:KAJ PERSONAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:KAJ PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KASSEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-476-7898
Mailing Address - Street 1:111 NORTHFIELD AVE STE 208A
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4730
Mailing Address - Country:US
Mailing Address - Phone:973-476-7898
Mailing Address - Fax:
Practice Address - Street 1:111 NORTHFIELD AVE STE 208A
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4730
Practice Address - Country:US
Practice Address - Phone:973-476-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities