Healthcare Provider Details
I. General information
NPI: 1215869722
Provider Name (Legal Business Name): NJ KOMMUNITY KONNECTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 6TH AVE APT 8
LONG BRANCH NJ
07740-7291
US
IV. Provider business mailing address
205 6TH AVE APT 8
LONG BRANCH NJ
07740-7291
US
V. Phone/Fax
- Phone: 732-768-5211
- Fax: 732-704-8119
- Phone: 732-768-5211
- Fax: 732-704-8119
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347D00000X |
| Taxonomy | Train |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ERNESTINA
R
ERNESTINA
Title or Position: CHW
Credential: ERNESTINA
Phone: 732-768-5211