Healthcare Provider Details

I. General information

NPI: 1750025045
Provider Name (Legal Business Name): NATIONAL SENIOR CARE NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2022
Last Update Date: 04/24/2022
Certification Date: 04/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 MAIN ST
HACKENSACK NJ
07601-5804
US

IV. Provider business mailing address

48645 VAN DYKE AVE STE 201
SHELBY TOWNSHIP MI
48317-2576
US

V. Phone/Fax

Practice location:
  • Phone: 201-912-4694
  • Fax:
Mailing address:
  • Phone: 586-506-1996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: EHTESHAM E ANSARI
Title or Position: CHAIRMAN
Credential:
Phone: 586-506-1996