Healthcare Provider Details

I. General information

NPI: 1316177074
Provider Name (Legal Business Name): IKHAYA WORLD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 KINDERKAMACK ROAD SUITE 204
EMERSON NJ
07630
US

IV. Provider business mailing address

70 KINDERKAMACK ROAD SUITE 204
EMERSON NJ
07630
US

V. Phone/Fax

Practice location:
  • Phone: 201-483-8490
  • Fax: 201-735-2111
Mailing address:
  • Phone: 201-483-8490
  • Fax: 201-735-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHPO131500&CTO373900
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberHPO131500-HCSF;CTO37
License Number StateNULL
# 7
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberHPO131500-HCSF;CTO37
License Number StateNJ
# 8
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. PATRICIA R. PREZTUNIK
Title or Position: PRESIDENT & OWNER
Credential:
Phone: 201-483-8490