Healthcare Provider Details

I. General information

NPI: 1083761399
Provider Name (Legal Business Name): MERCER STREET FRIENDS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DUNMORE AVE
EWING NJ
08618-1937
US

IV. Provider business mailing address

7 DUNMORE AVE
EWING NJ
08618-1937
US

V. Phone/Fax

Practice location:
  • Phone: 609-396-1505
  • Fax: 609-989-7157
Mailing address:
  • Phone: 609-396-1505
  • Fax: 609-989-7157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number71103
License Number StateNJ

VIII. Authorized Official

Name: MS. MARY JANE DARBEE
Title or Position: ADMINISTRATOR, FRIENDS HOME HEALTH
Credential: RN BSN
Phone: 609-396-1505