Provider Demographics
NPI:1720783608
Name:NEW JERSEY DIRECT CARE LLC
Entity Type:Organization
Organization Name:NEW JERSEY DIRECT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBIECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-905-5340
Mailing Address - Street 1:329 HARBOURTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-3309
Mailing Address - Country:US
Mailing Address - Phone:609-905-5340
Mailing Address - Fax:
Practice Address - Street 1:329 HARBOURTOWN BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-3309
Practice Address - Country:US
Practice Address - Phone:609-905-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health