- Enrollment id
- O20041111000361
- Enrollment state
- NJ
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1013999382
- Multiple npi flag
- N
- Ccn
- 317017
- Associate id
- 4082677984
- Organization name
- PATIENT CARE NEW JERSEY, INC.
- Doing business as name
- PATIENT CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 777 PASSAIC AVE
- Address line 2
- STE 595
- City
- CLIFTON
- State
- NJ
- Zip code
- 070121873