Healthcare Provider Details

I. General information

NPI: 1912041526
Provider Name (Legal Business Name): HEATH VILLAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 SCHOOLEYS MOUNTAIN RD
HACKETTSTOWN NJ
07840-4023
US

IV. Provider business mailing address

430 SCHOOLEYS MOUNTAIN RD
HACKETTSTOWN NJ
07840-4039
US

V. Phone/Fax

Practice location:
  • Phone: 908-979-8989
  • Fax: 908-684-5381
Mailing address:
  • Phone: 908-852-4801
  • Fax: 908-684-5074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number031402
License Number StateNJ

VIII. Authorized Official

Name: MS. MARY ELLEN BOVE
Title or Position: CEO
Credential: LNHA
Phone: 908-684-5220