Provider Demographics
NPI:1699760157
Name:ATLANTICARE HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:ATLANTICARE HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-407-2020
Mailing Address - Street 1:6550 DELILAH RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5142
Mailing Address - Country:US
Mailing Address - Phone:609-407-2020
Mailing Address - Fax:609-407-2021
Practice Address - Street 1:6550 DELILAH RD.
Practice Address - Street 2:SUITE 210
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5142
Practice Address - Country:US
Practice Address - Phone:609-407-2020
Practice Address - Fax:609-407-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22853251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5060508Medicaid
NJ5060508Medicaid