Provider Demographics
NPI:1831570480
Name:CENTURION ENTERPRISES DBA HOMEWELL CARE SERVICES
Entity type:Organization
Organization Name:CENTURION ENTERPRISES DBA HOMEWELL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-487-9220
Mailing Address - Street 1:15 DYATT PL
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6004
Mailing Address - Country:US
Mailing Address - Phone:201-487-9220
Mailing Address - Fax:201-487-9221
Practice Address - Street 1:15 DYATT PL
Practice Address - Street 2:FLOOR 2
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6004
Practice Address - Country:US
Practice Address - Phone:201-487-9220
Practice Address - Fax:201-487-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care