Provider Demographics
NPI:1740759455
Name:MAXCEN HOUSING SOCIETY INC., NEW JERSEY BRANCH
Entity type:Organization
Organization Name:MAXCEN HOUSING SOCIETY INC., NEW JERSEY BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN MAXCENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-959-4159
Mailing Address - Street 1:845 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-3674
Mailing Address - Country:US
Mailing Address - Phone:888-959-4159
Mailing Address - Fax:888-412-1704
Practice Address - Street 1:845 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3674
Practice Address - Country:US
Practice Address - Phone:888-959-4159
Practice Address - Fax:888-412-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJN0000106121OtherNJ