Provider Demographics
NPI:1265893663
Name:PRN CARE LLC
Entity type:Organization
Organization Name:PRN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MIELECH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:862-249-1300
Mailing Address - Street 1:790 BLOOMFIELD AVE
Mailing Address - Street 2:BUILDING E, SUITE 1
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1142
Mailing Address - Country:US
Mailing Address - Phone:862-249-1300
Mailing Address - Fax:
Practice Address - Street 1:790 BLOOMFIELD AVE
Practice Address - Street 2:BUILDING E, SUITE 1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1142
Practice Address - Country:US
Practice Address - Phone:862-249-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0210400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health