Provider Demographics
NPI:1588844195
Name:ADDUS HEALTHCARE (NEW JERSEY), INC
Entity type:Organization
Organization Name:ADDUS HEALTHCARE (NEW JERSEY), INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL CONTRACTS
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMARICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, MBA
Authorized Official - Phone:847-303-5300
Mailing Address - Street 1:17 JAMES ST
Mailing Address - Street 2:UNIT 6A
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3656
Mailing Address - Country:US
Mailing Address - Phone:973-743-4200
Mailing Address - Fax:973-742-4220
Practice Address - Street 1:17 JAMES ST
Practice Address - Street 2:UNIT 6A
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3656
Practice Address - Country:US
Practice Address - Phone:973-743-4200
Practice Address - Fax:973-742-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0097800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health