NPI 1063627545

Second Home Perth Amboy LLC

Organisation Adult Care Home Facility Perth Amboy, NJ

Practice location

Address: 420 Fayette St, Perth Amboy, NJ 08861-3835
Phone: (732) 826-8012
Fax: (732) 826-1961
Mailing address: 100 Hamilton Plz, Paterson, NJ 07505-2109

Authorised official

Name: Debroah Minassian
Title: President
Phone: (973) 279-2323

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence Z0SFLR (NJ)

Other Custodial Care Facility providers in New Jersey →

Registry record

NPI: 1063627545
Entity type: Organization
NPI issued: 10 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.