Provider Demographics
NPI:1194421024
Name:SAINT GABRIEL HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:SAINT GABRIEL HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-829-6830
Mailing Address - Street 1:12 SUSAN LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3703
Mailing Address - Country:US
Mailing Address - Phone:732-829-6830
Mailing Address - Fax:
Practice Address - Street 1:68 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1846
Practice Address - Country:US
Practice Address - Phone:732-829-6830
Practice Address - Fax:201-644-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health