Healthcare Provider Details

I. General information

NPI: 1396299566
Provider Name (Legal Business Name): HOSPICE OF SOUTHERN NEW JERSEY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LAUREL OAK RD
VOORHEES NJ
08043-4363
US

IV. Provider business mailing address

1100 LAUREL OAK RD
VOORHEES NJ
08043-4363
US

V. Phone/Fax

Practice location:
  • Phone: 856-661-2073
  • Fax: 856-661-2093
Mailing address:
  • Phone: 856-661-2073
  • Fax: 856-661-2093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN LOVE
Title or Position: CEO
Credential:
Phone: 856-679-2270