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Organization
SECOND HOME PERTH AMBOY LLC
Active
Organization
SECOND HOME PERTH AMBOY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBROAH MINASSIAN (PRESIDENT)
(973) 279-2323
Entity
Organization
Contact information
Practice address
420 FAYETTE ST, PERTH AMBOY, NJ 08861-3835
(732) 826-8012
(732) 826-1961
Mailing address
100 HAMILTON PLZ, PATERSON, NJ 07505-2109
(973) 279-2323
(973) 278-6284
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
Z0SFLR
NJ
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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