Provider Demographics
NPI:1427084664
Name:CARING HOSPICE OF SOUTH JERSEY LLC
Entity type:Organization
Organization Name:CARING HOSPICE OF SOUTH JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-901-6600
Mailing Address - Street 1:525 RTE 70 W
Mailing Address - Street 2:STE B15
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-901-6600
Mailing Address - Fax:732-905-4929
Practice Address - Street 1:133 GAITHER DR STE Q
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1710
Practice Address - Country:US
Practice Address - Phone:888-288-2951
Practice Address - Fax:856-439-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22982251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7341407Medicaid
311546Medicare Oscar/Certification