Provider Demographics
NPI:1043911076
Name:ALICE HOME HEALTH CARE
Entity type:Organization
Organization Name:ALICE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING RN
Authorized Official - Prefix:
Authorized Official - First Name:JESSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLACARLOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:551-226-1755
Mailing Address - Street 1:2 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4829
Mailing Address - Country:US
Mailing Address - Phone:917-780-8006
Mailing Address - Fax:
Practice Address - Street 1:234 16TH ST FL 4
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1196
Practice Address - Country:US
Practice Address - Phone:347-849-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health