Healthcare Provider Details

I. General information

NPI: 1790822740
Provider Name (Legal Business Name): DELIGHT CARE HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 US HIGHWAY 1 S 2ND FLOOR SUITE 3
EDISON NJ
08817-4491
US

IV. Provider business mailing address

485 US HIGHWAY 1 S 2ND FLOOR SUITE 3
EDISON NJ
08817-4491
US

V. Phone/Fax

Practice location:
  • Phone: 732-339-0050
  • Fax: 732-339-0065
Mailing address:
  • Phone: 732-339-0050
  • Fax: 732-339-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP#0059900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0110469
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MRS. MARINA SONTS
Title or Position: PRESIDENT
Credential: RN BSN
Phone: 732-339-0050