Provider Demographics
NPI:1104980705
Name:HOME SWEET HOME CARE, INC.
Entity type:Organization
Organization Name:HOME SWEET HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHULAMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GELBWACHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-886-2273
Mailing Address - Street 1:1072 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2650
Mailing Address - Country:US
Mailing Address - Phone:732-886-2273
Mailing Address - Fax:732-886-6399
Practice Address - Street 1:1072 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2650
Practice Address - Country:US
Practice Address - Phone:732-886-2273
Practice Address - Fax:732-886-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP00054700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0184560Medicaid