Provider Demographics
NPI:1194057232
Name:PROCARE HOME HEALTH CARE AGENCY, LLC
Entity type:Organization
Organization Name:PROCARE HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-466-9653
Mailing Address - Street 1:21 HIDDEN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1551
Mailing Address - Country:US
Mailing Address - Phone:856-466-9653
Mailing Address - Fax:888-573-7634
Practice Address - Street 1:41 UNIVERSITY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1873
Practice Address - Country:US
Practice Address - Phone:215-809-2029
Practice Address - Fax:888-573-7634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-30
Last Update Date:2010-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03950501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health