# JERSEY STAKE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Visiting Angels of Fort Lee
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093444721
- **Authorized official:** MICHAEL TUCCI (PRESIDENT)
- **Authorized official phone:** (201) 242-0305

## Contact information

- **Practice address:** 2125 CENTER AVE STE 110, FORT LEE, NJ 07024-5821
- **Practice address phone:** (201) 242-0305
- **Practice address fax:** (201) 242-0345
- **Mailing address:** 19 ORCHARD PL, HAWTHORNE, NJ 07506-3123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/08/2022
- **Last updated:** 01/12/2023