Provider Demographics
NPI:1861893596
Name:LAYCHOCK CALLAHAN LLC
Entity type:Organization
Organization Name:LAYCHOCK CALLAHAN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYCHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-641-7200
Mailing Address - Street 1:3153 FIRE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9607
Mailing Address - Country:US
Mailing Address - Phone:609-641-7200
Mailing Address - Fax:609-641-7110
Practice Address - Street 1:3153 FIRE RD
Practice Address - Street 2:SUITE B
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9607
Practice Address - Country:US
Practice Address - Phone:609-641-7200
Practice Address - Fax:609-641-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0065700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health