Healthcare Provider Details

I. General information

NPI: 1699712166
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64-66 BRIDGE AVENUE
RED BANK NJ
07701
US

IV. Provider business mailing address

806 5TH AVE
ASBURY PARK NJ
07712-5363
US

V. Phone/Fax

Practice location:
  • Phone: 732-219-6620
  • Fax: 732-219-6625
Mailing address:
  • Phone: 732-502-5144
  • Fax: 732-264-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number23983
License Number StateNJ

VIII. Authorized Official

Name: MS. DARLENE RICE
Title or Position: SCHEDULING & CREDENTIALING
Credential:
Phone: 732-502-5144