| NPI | 1619190428 |
|---|---|
| Other Name | TRI STATE DOMESTIC |
| Entity Type | Organization |
| Authorized Contact | ROBERT MCGOWAN Director 973-928-3428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: NJ 35SI00033100) |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based (Licence: NJ 35SI00033100) |
| 251J00000X Nursing Care (Licence: NJ 35SI00033100) | |
| 251T00000X PACE Provider Organization (Licence: NJ 35SI00033100) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |