Healthcare Provider Details

I. General information

NPI: 1841581303
Provider Name (Legal Business Name): BETTY NURSING SERVICE/HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 LIBERTY AVE SUITE 3
HILLSIDE NJ
07205-2055
US

IV. Provider business mailing address

1369 NORTH AVE SUITE 22
ELIZABETH NJ
07208-2626
US

V. Phone/Fax

Practice location:
  • Phone: 201-567-1044
  • Fax: 201-567-2201
Mailing address:
  • Phone: 201-567-1044
  • Fax: 201-567-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHP0066100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0066100
License Number StateNJ

VIII. Authorized Official

Name: MS. BETTY ONYEAHARA
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 201-567-1044