Provider Demographics
NPI:1649615840
Name:MOBILITY SPECIAL HOME CARE SERVICES, LLC DBA EXECUTIVE CARE
Entity type:Organization
Organization Name:MOBILITY SPECIAL HOME CARE SERVICES, LLC DBA EXECUTIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABALFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-599-9794
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:ADELPHIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07710-0213
Mailing Address - Country:US
Mailing Address - Phone:800-974-3009
Mailing Address - Fax:800-974-3009
Practice Address - Street 1:958 ADELPHIA RD
Practice Address - Street 2:
Practice Address - City:FREEEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07710
Practice Address - Country:US
Practice Address - Phone:800-974-3009
Practice Address - Fax:800-974-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health