Provider Demographics
NPI:1801289475
Name:GARDEN STATE ELDERCARE
Entity type:Organization
Organization Name:GARDEN STATE ELDERCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-378-9100
Mailing Address - Street 1:71 VALLEY ST STE 300B
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2825
Mailing Address - Country:US
Mailing Address - Phone:973-378-9100
Mailing Address - Fax:
Practice Address - Street 1:71 VALLEY ST STE 300B
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2825
Practice Address - Country:US
Practice Address - Phone:973-378-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care