Provider Demographics
NPI:1801982012
Name:FAMILY CHOICE HOSPICE, LLC
Entity type:Organization
Organization Name:FAMILY CHOICE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-396-1200
Mailing Address - Street 1:77 BRANT AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1560
Mailing Address - Country:US
Mailing Address - Phone:732-396-1200
Mailing Address - Fax:732-396-0010
Practice Address - Street 1:77 BRANT AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1560
Practice Address - Country:US
Practice Address - Phone:732-396-1200
Practice Address - Fax:732-396-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24101251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0129071Medicaid
NJ0129071Medicaid