Basic Information
| Provider Information | |||||||||
| NPI: | 1649561093 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMPASSIONATE CARE HOSPICE OF SOUTHERN NEW JERSEY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HIGHLAND DR | ||||||||
| Address2: | SUITE 624 | ||||||||
| City: | WESTAMPTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080605120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092671178 | ||||||||
| FaxNumber: | 6092673499 | ||||||||
| Practice Location | |||||||||
| Address1: | 518 S SHORE RD | ||||||||
| Address2: | |||||||||
| City: | MARMORA | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082231215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092671178 | ||||||||
| FaxNumber: | 6092673499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2011 | ||||||||
| LastUpdateDate: | 04/20/2011 | ||||||||
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| AuthorizedOfficialLastName: | GREY | ||||||||
| AuthorizedOfficialFirstName: | JUDITH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6095186814 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.