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SECOND HOME PERTH AMBOY LLC
NPI 1063627545
Custodial Care Facility - Adult Care Home in Perth Amboy, NJ

Active since May 10, 2007
420 FAYETTE ST, PERTH AMBOY, NJ 08861(732) 826-8012(732) 826-1961 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Second Home Perth Amboy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SECOND HOME PERTH AMBOY LLC (NPI 1063627545) is a healthcare organization registered as an adult care home in Perth Amboy, New Jersey and active in the NPI registry since May 2007. The organization lists Debroah Minassian, President, as its authorized official.

NPPES Registry Identity

NPI1063627545
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameSECOND HOME PERTH AMBOY LLC
Location Address420 FAYETTE STPerth Amboy, NJ 08861-3835
Mailing Address100 Hamilton PlzPaterson, NJ 07505-2109 · (973) 279-2323 · Fax (973) 278-6284
Phone(732) 826-8012
Fax(732) 826-1961
Organization SubpartNo
Authorized OfficialDebroah MinassianPresident · (973) 279-2323
Enumeration DateMay 10, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1063627545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in NJ · Z0SFLR
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
420 FAYETTE ST, Perth Amboy, NJ 08861
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Other Identifiers 1

Medicaid7667043NJ

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

2ND HOME PERTH AMBOY OPERATIONS, LLC
Clinic/Center (Adult Day Care)
420 FAYETTE ST
PERTH AMBOY, NJ 08861
Middlesex County (973) 395-0555
MS. CHRISTINA M WONG OT
Occupational Therapist
420 FAYETTE ST
PERTH AMBOY, NJ 08861
Middlesex County (732) 549-0743
2ND HOME PERTH AMBOY LLC
Nursing Facility/Intermediate Care Facility
420 FAYETTE ST
PERTH AMBOY, NJ 08861
Middlesex County (732) 826-1961
CAREPLUS REHAB LLC
Clinic/Center (Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF))
420 FAYETTE ST
PERTH AMBOY, NJ 08861
Middlesex County (732) 423-9094

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Second Home Perth Amboy LLC's NPI number?

The NPI number for Second Home Perth Amboy LLC is 1063627545. It was assigned to this organization in the NPPES registry on May 10, 2007.

Where is Second Home Perth Amboy LLC located?

Second Home Perth Amboy LLC is located at 420 Fayette St, Perth Amboy, NJ 08861. The listed phone number is (732) 826-8012.

What is Second Home Perth Amboy LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Second Home Perth Amboy LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.