Provider Demographics
NPI:1528242591
Name:HOLY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:HOLY HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIEJO
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:CHERESTAL
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:609-654-5900
Mailing Address - Street 1:53 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2442
Mailing Address - Country:US
Mailing Address - Phone:609-654-5900
Mailing Address - Fax:609-654-5966
Practice Address - Street 1:53 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2442
Practice Address - Country:US
Practice Address - Phone:609-654-5900
Practice Address - Fax:609-654-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0100900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health