Provider Demographics
NPI:1124455746
Name:HOME INSTEAD SENIOR CARE
Entity type:Organization
Organization Name:HOME INSTEAD SENIOR CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:609-607-1900
Mailing Address - Street 1:1 MEMORIAL DR
Mailing Address - Street 2:UNIT 102
Mailing Address - City:WARETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08758-2572
Mailing Address - Country:US
Mailing Address - Phone:609-607-1900
Mailing Address - Fax:609-607-0682
Practice Address - Street 1:1 MEMORIAL DR
Practice Address - Street 2:UNIT 102
Practice Address - City:WARETOWN
Practice Address - State:NJ
Practice Address - Zip Code:08758-1762
Practice Address - Country:US
Practice Address - Phone:609-607-1900
Practice Address - Fax:609-607-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO117800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health