Provider Demographics
NPI:1093698607
Name:NEW FOUNTAIN HOMECARE LLC
Entity type:Organization
Organization Name:NEW FOUNTAIN HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-398-2287
Mailing Address - Street 1:3 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-1562
Mailing Address - Country:US
Mailing Address - Phone:651-398-2287
Mailing Address - Fax:
Practice Address - Street 1:3 MONROE AVE
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-1562
Practice Address - Country:US
Practice Address - Phone:651-398-2287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health