Organization Name: | TOTAL INDEPENDENT COMMUNITY INCLUSION OF NJ |
NPI Number: | 1588097000 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONY IHUOMA (CEO) |
Mailing Address: | 24 Linden Ave Irvington |
State: | NJ US |
Postal Code: | 071112521 |
Phone Number: | 9733931256 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2013 |
NPI Last Update Date: | 08/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |