Provider Demographics
NPI:1740678861
Name:FREEHOLD HEALTHCARE, LLC
Entity type:Organization
Organization Name:FREEHOLD HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:NOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-812-9777
Mailing Address - Street 1:40 VREELAND AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1159
Mailing Address - Country:US
Mailing Address - Phone:973-812-9777
Mailing Address - Fax:973-812-0518
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:SUITE 601
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1524
Practice Address - Country:US
Practice Address - Phone:973-812-9777
Practice Address - Fax:973-812-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care