Basic Information
| Provider Information | |||||||||
| NPI: | 1821752304 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TOTALCARENJ | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 WOOD AVE S STE 600 | ||||||||
| Address2: | |||||||||
| City: | ISELIN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8622356579 | ||||||||
| FaxNumber: | 9734981336 | ||||||||
| Practice Location | |||||||||
| Address1: | 33 WOOD AVE S STE 600 | ||||||||
| Address2: | |||||||||
| City: | ISELIN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8622356579 | ||||||||
| FaxNumber: | 9734981336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2021 | ||||||||
| LastUpdateDate: | 10/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | ALAO | ||||||||
| AuthorizedOfficialFirstName: | ADEWALE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8622356579 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 385HR2060X | Y | Respite Care Facility | Respite Care | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
No ID Information.