Provider Demographics
NPI:1124338967
Name:SKYLINE CARE, LLC
Entity type:Organization
Organization Name:SKYLINE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-809-2903
Mailing Address - Street 1:505 MARLBORO RD STE 5
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1235
Mailing Address - Country:US
Mailing Address - Phone:201-635-1195
Mailing Address - Fax:201-635-1194
Practice Address - Street 1:120 PARK END PL
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1116
Practice Address - Country:US
Practice Address - Phone:973-965-0366
Practice Address - Fax:973-965-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0136600253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care