HOMESIDE HOSPICE LLC NPI 1194787366

NPI Information

NPI: 1194787366
Provider Name: HOMESIDE HOSPICE, LLC

Doing Business As: HOMESIDE HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
67 WALNUT AVENUE
SUITE 205
CLARK, NJ
ZIP 07066
Phone: (732) 381-3444
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HOMESIDE HOSPICE, LLC is a hospice care community based in Clark, NJ. HOMESIDE HOSPICE, LLC NPI is 1194787366. The provider is registered as an organization entity type.
The provider Is Doing Business As Homeside Hospice.

The provider's business location address is:

67 WALNUT AVENUE
SUITE 205
CLARK, NJ
ZIP 07066-444
Phone: (732) 381-3444
Fax: (732) 381-3445

The provider's authorized official is Kristin Barnable .
The authorized official title is Managing Partner/administrator and has the following contact phone number (732) 381-3444.

The CLIA number assigned to this NPI record is 31D1039179 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 9/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		23391	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	311559	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY	MEDICARE PROVIDER NUMBER
2	0086436	MEDICAID	NEW JERSEY
3	23391	OTHER	NEW JERSEY	DEPT OF HEALTH LICENSE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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