Provider Demographics
NPI:1992550735
Name:THERESA'S PLACE HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:THERESA'S PLACE HOMECARE AGENCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:LASHELLE
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-218-3092
Mailing Address - Street 1:185 CENTRAL AVE STE 607C
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3332
Mailing Address - Country:US
Mailing Address - Phone:862-218-3092
Mailing Address - Fax:
Practice Address - Street 1:560 MAIN ST APT 416
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2225
Practice Address - Country:US
Practice Address - Phone:862-218-3092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care