Provider Demographics
NPI:1467193789
Name:AMANA CARE
Entity type:Organization
Organization Name:AMANA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:UDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-792-1667
Mailing Address - Street 1:350 BLACKWOOD CLEMENTON RD APT 2206
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-5279
Mailing Address - Country:US
Mailing Address - Phone:917-792-1667
Mailing Address - Fax:
Practice Address - Street 1:350 BLACKWOOD CLEMENTON RD APT 2206
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-5279
Practice Address - Country:US
Practice Address - Phone:917-792-1667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health