Provider Demographics
NPI:1255785622
Name:ACADIA HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:ACADIA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-573-5926
Mailing Address - Street 1:PO BOX 1739
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-1739
Mailing Address - Country:US
Mailing Address - Phone:732-573-5926
Mailing Address - Fax:973-400-0049
Practice Address - Street 1:1851 HOOPER AVE STE 1B
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8150
Practice Address - Country:US
Practice Address - Phone:732-255-7500
Practice Address - Fax:973-400-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0127201251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0492116Medicaid