Provider Demographics
NPI:1316434244
Name:ENDURING HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:ENDURING HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHIPUE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:609-285-9358
Mailing Address - Street 1:17 CARNATION RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5336
Mailing Address - Country:US
Mailing Address - Phone:609-285-9358
Mailing Address - Fax:609-448-0271
Practice Address - Street 1:17 CARNATION RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-5336
Practice Address - Country:US
Practice Address - Phone:609-285-9358
Practice Address - Fax:609-448-0271
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENDURING HEALTH CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0450251420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1104235092OtherNPI
NY04738794Medicaid