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Organization

IMMACULATE ESSENTIAL CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERICK POLLEY (DIRECTOR)
(856) 524-3140
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
06/19/2023
Last updated
06/19/2023
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