Provider Demographics
NPI:1770397770
Name:CLOSEATHOME LLC
Entity type:Organization
Organization Name:CLOSEATHOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:TAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-635-1704
Mailing Address - Street 1:28 SPRING ST UNIT 441
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-6901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-6531
Practice Address - Country:US
Practice Address - Phone:609-635-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0398100OtherSTATE LICENSE NUMBERS