Healthcare Provider Details

I. General information

NPI: 1225696859
Provider Name (Legal Business Name): BLUE COMMUNITY CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 CENTRAL AVE
PLAINFIELD NJ
07060-2344
US

IV. Provider business mailing address

990 CENTRAL AVE
PLAINFIELD NJ
07060-2344
US

V. Phone/Fax

Practice location:
  • Phone: 908-422-1724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SINJED DEPINA-VEIGA
Title or Position: OWNER
Credential:
Phone: 908-422-1724