Provider Demographics
NPI:1982769410
Name:FIDELITY CARE,INC
Entity Type:Organization
Organization Name:FIDELITY CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-478-3500
Mailing Address - Street 1:113 DEWITT ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2745
Mailing Address - Country:US
Mailing Address - Phone:973-478-3500
Mailing Address - Fax:
Practice Address - Street 1:113 DEWITT ST
Practice Address - Street 2:SUITE 204
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2745
Practice Address - Country:US
Practice Address - Phone:973-478-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0041400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061581Medicaid