Provider Demographics
NPI:1871312769
Name:HOME SURE HOME CARE LLC
Entity type:Organization
Organization Name:HOME SURE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERIFF
Authorized Official - Suffix:
Authorized Official - Credentials:CHHA/SOCIAL WORKER
Authorized Official - Phone:848-319-0900
Mailing Address - Street 1:99 WINDING WOOD DR APT 5B
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2068
Mailing Address - Country:US
Mailing Address - Phone:848-319-0900
Mailing Address - Fax:
Practice Address - Street 1:37 EASTON AVE # 200
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1830
Practice Address - Country:US
Practice Address - Phone:732-325-4348
Practice Address - Fax:732-844-3610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services