# IMMACULATE ESSENTIAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447935242
- **Authorized official:** FREDERICK POLLEY (DIRECTOR)
- **Authorized official phone:** (856) 524-3140

## Contact information

- **Practice address:** 4 HADDONFIELD RD STE 204, CHERRY HILL, NJ 08002-1467
- **Practice address phone:** (856) 524-3140
- **Practice address fax:** (855) 674-1833
- **Mailing address:** 2995 CHAPEL AVE W APT 1S, CHERRY HILL, NJ 08002-3911
- **Mailing address phone:** (856) 524-3140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 06/19/2023