Organization
ISMARTHOMECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYWAN DARRELL MATA (CEO)
(908) 445-1200
Entity
Organization
Contact information
Practice address
2598 E SUNRISE BLVD, FT LAUDERDALE, FL 33304-3230
(908) 445-1200
Mailing address
1121 THOMPSON AVE, ROSELLE, NJ 07203-2810
(908) 445-1200
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
02/07/2025
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