SECOND HOME, LLC (NPI# 1235273905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235273905 |
| Entity Type | Organization |
| Organization Name | SECOND HOME, LLC |
| Practice Address |
100 Hamilton Plz Paterson NJ 07505-2109 |
| Practice Telephone | 9732787065 |
| Practice Fax Number | 9732784773 |
| Mailing Telephone | 9732787065 |
| Mailing Fax Number | 9732784773 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID M MYERS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9732787065 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 708112 | NJ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 7667001 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | SECOND HOME, LLC | 1813 Bennett Drive Apt 82, West Des Moines, IA 50265 |
| Colorado Business Entities | Second Home, LLC | 319 Harrison Avenue, Loveland, CO 80537 |
| New York State Corporations | SECOND HOME, LLC | 9835 Old State Road, Angelica, New York 14709 |
| Street Address |
100 HAMILTON PLZ |
| City | PATERSON |
| State | NJ |
| Zip Code | 07505-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194794636 | Confident Care Corp | Home Health | 100 Hamilton Plz, Suite 415, Paterson, NJ 07505-2109 | 2006-03-16 |
| 1265990279 | Women and Families Ascending Association | Community/Behavioral Health | 100 Hamilton Plz, Paterson, NJ 07505-2109 | 2019-03-08 |
| 1043673858 | Howe Avenue Rehabilitation LLC | Chiropractor | 100 Hamilton Plz, Ste 501, Paterson, NJ 07505-2109 | 2016-03-30 |
| 1366743874 | Xaioming Gao | Physical Therapist | 100 Hamilton Plz, Paterson, NJ 07505-2109 | 2010-11-15 |
| 1366681405 | 2nd Home Paterson Operations, LLC | Clinic/Center | 100 Hamilton Plz, Ground Floor, Paterson, NJ 07505-2109 | 2009-02-12 |
| 1619114741 | Paul F Fulford Phd Pa | Psychologist | 100 Hamilton Plz, Suite 1411, Paterson, NJ 07505-2109 | 2009-01-12 |
| 1467608224 | Sudha Malhotra | Physical Therapist | 100 Hamilton Plz, 3rd Flr, Paterson, NJ 07505-2109 | 2008-08-13 |
| 1871749630 | Richard Benjamin S. Manahan | Physical Therapist | 100 Hamilton Plz, 3rd Flr, Paterson, NJ 07505-2109 | 2008-08-13 |
| 1013163872 | Christian P Verzosa | Physical Therapist | 100 Hamilton Plz, 3rd Flr, Paterson, NJ 07505-2109 | 2008-08-13 |
| 1417103698 | Ronaldo A Lim | Physical Therapist | 100 Hamilton Plz, 3rd Flr, Paterson, NJ 07505-2109 | 2008-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598283202 | Cerebral Palsy of North Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 685 691 14th St, Paterson, NJ 07505 | 2017-09-01 |
| 1700031283 | Robert Rekker | Psychologist | 100 Hamilton Plz Ste 101, Paterson, NJ 07505 | 2008-11-25 |
| 1568664951 | James John Hussey | Social Worker | 56 Hamilton S, Paterson, NJ 07505 | 2007-06-05 |
| 1659414910 | Stephen Sherman | Dentist | 1 West Broadway, West Broadway Dental Pa, Paterson, NJ 07505 | 2007-02-15 |
| 1629089909 | Smile Central Dental PC | Dentist | 140 Market Street, 3rd Floor, Paterson, NJ 07505 | 2006-08-11 |
| 1619969581 | Damon House, Inc. | Substance Abuse Rehabilitation Facility | 175 Market St., Paterson, NJ 07505 | 2005-08-17 |
| 1295228377 | Jayasree Dokku | Pharmacist | 102 Broadway, Paterson, NJ 07505 | 2018-06-12 |
| 1619473089 | Meena Al-talib | Dentist | 140 Market St, Paterson, NJ 07505 | 2018-04-03 |
| 1083830384 | Mahir Saleh | Dentist | 1 West Broadway, West Broadway Dental Pa, Paterson, NJ 07505 | 2007-04-17 |
| 1801929591 | West Broadway Dental Pa | Dentist | 1 West Broadway, Paterson, NJ 07505 | 2007-03-13 |
| Find all providers in zip 07505 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073724134 | St. Joseph's Rest Home for Aged Women | Nursing Facility/Intermediate Care Facility | 46 Preakness Ave, Paterson, NJ 07522-1420 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018978 | Hamilton Operator, LLC | Nursing Facility/Intermediate Care Facility | 1501 State Highway 33, Hamilton Square, NJ 08690-1705 | 2019-05-10 |
| 1316399744 | Robert Anokye | Nursing Facility/Intermediate Care Facility | 234 Summit Ave, New Milford, NJ 07646-1714 | 2016-07-11 |
| 1548620701 | Wishing Well Adult Day Health Care, LLC | Nursing Facility/Intermediate Care Facility | 3450 Princeton Pike Ste 120, Lawrenceville, NJ 08648-1206 | 2016-03-02 |
| 1437549169 | Search Day Program | Nursing Facility/Intermediate Care Facility | 144 Robertsville Road, Freehold, NJ 07728 | 2015-02-03 |
| 1295149201 | Lincoln Park Care Center | Nursing Facility/Intermediate Care Facility | 308 Park Ave, 2nd Fl., Orange, NJ 07050-2914 | 2014-06-17 |
| 1811278047 | Ark Internal Medicine LLC | Nursing Facility/Intermediate Care Facility | 26 Richard Rd, Monmouth Junction, NJ 08852-2522 | 2011-09-01 |
| 1215260427 | Universal Medical Care | Nursing Facility/Intermediate Care Facility | 883 Schyuler Ave, # 23, Kearny, NJ 07032-4236 | 2009-09-08 |
| 1396975710 | Rooms To Grow | Nursing Facility/Intermediate Care Facility | 31 Brown St, Maplewood, NJ 07040-3012 | 2009-07-20 |
| 1558517482 | Salem County Improvement Authority | Nursing Facility/Intermediate Care Facility | 438 Salem Woodstown Rd, Salem, NJ 08079-4220 | 2008-08-12 |
| 1285801399 | Shore Professional Services LLC | Nursing Facility/Intermediate Care Facility | 1354 Forest Glen Ct, Toms River, NJ 08755-1386 | 2008-05-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.