Provider Demographics
NPI:1174588925
Name:VALLEY HOME CARE, INC
Entity type:Organization
Organization Name:VALLEY HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:JOSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTALATIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-291-6017
Mailing Address - Street 1:15 ESSEX RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1451
Mailing Address - Country:US
Mailing Address - Phone:201-291-6000
Mailing Address - Fax:201-291-6260
Practice Address - Street 1:15 ESSEX RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1451
Practice Address - Country:US
Practice Address - Phone:201-291-6000
Practice Address - Fax:201-291-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22381251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3687805Medicaid
NJ317008Medicare ID - Type Unspecified