Healthcare Provider Details

I. General information

NPI: 1609784016
Provider Name (Legal Business Name): PEBBLES GREEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 PATRIOTS WAY # 226
SCOTCH PLAINS NJ
07076-3502
US

IV. Provider business mailing address

179 WILLIAM ST
EAST ORANGE NJ
07017-4708
US

V. Phone/Fax

Practice location:
  • Phone: 973-943-2077
  • Fax:
Mailing address:
  • Phone: 973-943-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMEKA ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 973-943-2077