Healthcare Provider Details

I. General information

NPI: 1508634650
Provider Name (Legal Business Name): NIMA CARE SUPPORTED LIVING LLP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 PYNE RD
SOUTH BRUNSWICK NJ
08824-1012
US

IV. Provider business mailing address

781 HAMILTON ST
SOMERSET NJ
08873-3160
US

V. Phone/Fax

Practice location:
  • Phone: 732-325-7714
  • Fax:
Mailing address:
  • Phone: 732-325-7714
  • 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: HADIATU BARRIE
Title or Position: CEO
Credential:
Phone: 732-325-7714