Provider Demographics
NPI:1700231362
Name:LARES HOME CARE, LLC
Entity type:Organization
Organization Name:LARES HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROYDEN
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:KLEINERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:732-566-1112
Mailing Address - Street 1:1000 ROUTE 34
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3473
Mailing Address - Country:US
Mailing Address - Phone:732-566-1044
Mailing Address - Fax:732-566-1044
Practice Address - Street 1:1000 ROUTE 34
Practice Address - Street 2:SUITE 204
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3473
Practice Address - Country:US
Practice Address - Phone:732-566-1044
Practice Address - Fax:732-566-1044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LARES HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0204800253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care