Organization
VINTAGE LOVE HOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA LISA BAKER RN (CEO)
(856) 364-4210
Entity
Organization
Contact information
Practice address
1 EVES DR STE 111, MARLTON, NJ 08053-3125
(856) 364-4210
Mailing address
971 US HIGHWAY 202 N STE R, BRANCHBURG, NJ 08876-3757
(856) 364-4210
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/05/2025
Last updated
05/27/2025
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