1851770234 NPI number — MOBILITY SPECIAL HOME CARE SERVICES LLC

Table of content: MS. MEGAN E. SPRAW L.P.C.A. (NPI 1982039368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851770234 NPI number — MOBILITY SPECIAL HOME CARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOBILITY SPECIAL HOME CARE SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851770234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 213
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADELPHIA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-308-1512
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
958 ADELPHIA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEHOLD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07728-8890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-308-1512
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CABALFIN
Authorized Official First Name:
SENEN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CHIEF NURSE OFFICER
Authorized Official Telephone Number:
732-599-9794

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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