Provider Demographics
NPI:1215293907
Name:GEMINI HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:GEMINI HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-753-8999
Mailing Address - Street 1:22 QUACKENBUSH AVE.
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628
Mailing Address - Country:US
Mailing Address - Phone:201-753-8999
Mailing Address - Fax:201-784-1265
Practice Address - Street 1:22 QUACKENBUSH AVE.
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628
Practice Address - Country:US
Practice Address - Phone:201-753-8999
Practice Address - Fax:201-784-1265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0163100251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care