Provider Demographics
NPI:1992943559
Name:YOUR COMMUNITY HOME HEALTH CARE, L.L.C
Entity type:Organization
Organization Name:YOUR COMMUNITY HOME HEALTH CARE, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA-MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:201-751-4914
Mailing Address - Street 1:2035 KENNEDY BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6362
Mailing Address - Country:US
Mailing Address - Phone:201-751-4914
Mailing Address - Fax:201-751-4916
Practice Address - Street 1:2035 KENNEDY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6362
Practice Address - Country:US
Practice Address - Phone:201-751-4914
Practice Address - Fax:201-751-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0105000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health