Provider Demographics
NPI:1023875309
Name:CARECONNECT SUPPORTED LIVING
Entity type:Organization
Organization Name:CARECONNECT SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-257-1057
Mailing Address - Street 1:502 DILLION CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5510
Mailing Address - Country:US
Mailing Address - Phone:908-257-1057
Mailing Address - Fax:
Practice Address - Street 1:21 LINCOLN PL APT K
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4054
Practice Address - Country:US
Practice Address - Phone:908-257-1057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care