Healthcare Provider Details
I. General information
NPI: 1235330697
Provider Name (Legal Business Name): COUNTY OF BERGEN - SENIOR CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/31/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
327 EAST RIDGEWOOD AVENUE
PARAMUS NJ
07652-4895
US
IV. Provider business mailing address
327 EAST RIDGEWOOD AVENUE
PARAMUS NJ
07652-4895
US
V. Phone/Fax
- Phone: 201-634-2820
- Fax: 201-599-6270
- Phone: 201-634-2820
- Fax: 201-599-6270
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GREGORY
CONDAL
Title or Position: FISCAL OPERATIONS OFFICER
Credential:
Phone: 201-634-2680