Provider Demographics
NPI:1528342896
Name:GRACE JEAN, LLC DBA SYNERGY HOMECARE
Entity type:Organization
Organization Name:GRACE JEAN, LLC DBA SYNERGY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARADIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-561-4306
Mailing Address - Street 1:212 BELLEVUE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1722
Mailing Address - Country:US
Mailing Address - Phone:609-561-4306
Mailing Address - Fax:866-884-0430
Practice Address - Street 1:212 BELLEVUE AVE FL 2
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1722
Practice Address - Country:US
Practice Address - Phone:609-561-4306
Practice Address - Fax:866-884-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0133200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health