Second Home Perth Amboy LLC
Custodial Care Facility, Adult Care Home in Perth Amboy, New Jersey
1063627545- Practice location
- 420 Fayette St, Perth Amboy, NJ 08861-3835
- Phone
- 732-826-8012
- Fax
- 732-826-1961
- Last updated
- August 22, 2020
Second Home Perth Amboy LLC is a healthcare organization based in Perth Amboy, NJ. Second Home Perth Amboy LLC practices in Perth Amboy, NJ. The NPI Number for Second Home Perth Amboy LLC is 1063627545 and holds a License No. Z0SFLR (NJ). The current practice location address for Second Home Perth Amboy LLC is 420 Fayette St, Perth Amboy, NJ 08861-3835 and can be reached out via phone at 732-826-8012 and via fax at 732-826-1961.
Provider Profile Details
- NPI Number
- 1063627545
- Provider Name
- Second Home Perth Amboy LLC
- Provider Entity Type
- Organization
- Address
- 420 Fayette St, Perth Amboy, NJ 08861-3835
- Phone Number
- 732-826-8012
- Fax Number
- 732-826-1961
- Primary Taxonomy
- Custodial Care Facility, Adult Care Home · 311ZA0620X
- Organization Subpart
- No
- Authorized Official
- Mrs. Debroah Minassian · President · 973-279-2323
- Provider Enumeration Date
- May 10, 2007
- Last Update Date
- August 22, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 420 Fayette St
Perth Amboy, NJ 08861-3835 - City
- Perth Amboy
- State
- New Jersey
- Zip
- 08861-3835
- Phone Number
- 732-826-8012
- Fax Number
- 732-826-1961
Provider Business Mailing Address Details
- Address
- 100 Hamilton Plz
Paterson, NJ 07505-2109 - City
- Paterson
- State
- NJ
- Zip
- 07505-2109
- Phone Number
- 973-279-2323
- Fax Number
- 973-278-6284
License Information
- License Number
- Z0SFLR
- License State
- NJ
- Taxonomy
- Custodial Care Facility, Adult Care Home · 311ZA0620X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Second Home Perth Amboy LLC?
The NPI number of Second Home Perth Amboy LLC is 1063627545. It was assigned on May 10, 2007 and is currently active in the NPPES registry.
What is the specialty of Second Home Perth Amboy LLC?
Second Home Perth Amboy LLC is registered under the primary taxonomy Custodial Care Facility, Adult Care Home (code 311ZA0620X), licensed in NJ under license number Z0SFLR.
Where does Second Home Perth Amboy LLC practice?
The practice location is 420 Fayette St, Perth Amboy, NJ 08861-3835. The office can be reached at 732-826-8012 (phone) or 732-826-1961 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1063627545 directly on the NPPES registry website.