Healthcare Provider Details

I. General information

NPI: 1376528224
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF ENGLEWOOD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N DEAN ST STE 2C
ENGLEWOOD NJ
07631-2524
US

IV. Provider business mailing address

23 MAIN ST STE D1
HOLMDEL NJ
07733-2136
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3333
  • Fax: 201-894-1710
Mailing address:
  • Phone: 732-224-6914
  • Fax: 732-784-9710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number22250
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number22745
License Number StateNJ

VIII. Authorized Official

Name: PETER GAYLORD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 800-862-3330