Provider Demographics
NPI:1962903765
Name:HOME INSTEAD SENIOR CARE
Entity type:Organization
Organization Name:HOME INSTEAD SENIOR CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-985-6367
Mailing Address - Street 1:14 N MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3001
Mailing Address - Country:US
Mailing Address - Phone:856-985-6367
Mailing Address - Fax:856-985-6807
Practice Address - Street 1:14 N MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3001
Practice Address - Country:US
Practice Address - Phone:856-985-6367
Practice Address - Fax:856-985-6807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0097600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherOTHER