Provider Demographics
NPI:1316657174
Name:AHAVAH HOME LLC
Entity type:Organization
Organization Name:AHAVAH HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PIER
Authorized Official - Middle Name:
Authorized Official - Last Name:GASMENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-595-7353
Mailing Address - Street 1:36 ORANGEBURGH RD
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-7443
Mailing Address - Country:US
Mailing Address - Phone:863-595-7353
Mailing Address - Fax:
Practice Address - Street 1:336 WILLETT AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2511
Practice Address - Country:US
Practice Address - Phone:401-437-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility