Provider Demographics
NPI:1114789732
Name:LIFE & HEALTH HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:LIFE & HEALTH HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-688-8288
Mailing Address - Street 1:143 B SMITH ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861
Mailing Address - Country:US
Mailing Address - Phone:732-444-3244
Mailing Address - Fax:732-444-3114
Practice Address - Street 1:143B SMITH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4345
Practice Address - Country:US
Practice Address - Phone:732-444-3244
Practice Address - Fax:732-444-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health