Healthcare Provider Details

I. General information

NPI: 1750064424
Provider Name (Legal Business Name): WELLNESS-AT-HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 HWY 35 STE 205E
OAKHURST NJ
07755-2759
US

IV. Provider business mailing address

1806 HWY 35 STE 205E
OAKHURST NJ
07755-2759
US

V. Phone/Fax

Practice location:
  • Phone: 732-610-4998
  • Fax:
Mailing address:
  • Phone: 732-610-4998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARJORIE PIERRE JEROME
Title or Position: OWNER
Credential: RN, MSN, PMH-BC
Phone: 732-610-4998