Provider Demographics
NPI:1952692774
Name:WCH COMPANION CARE
Entity Type:Organization
Organization Name:WCH COMPANION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-513-8041
Mailing Address - Street 1:703 LIBERTY PLACE
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081
Mailing Address - Country:US
Mailing Address - Phone:856-302-6590
Mailing Address - Fax:
Practice Address - Street 1:2002 LIBERTY PL
Practice Address - Street 2:SUITE 703
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5707
Practice Address - Country:US
Practice Address - Phone:856-513-8041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WCH COMPANION CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-27
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ256Z00000X253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care