Healthcare Provider Details
I. General information
NPI: 1194206516
Provider Name (Legal Business Name): PROMISE CARE OF HUDSON COUNTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2018
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4914 KENNEDY BLVD W STE 203
WEST NEW YORK NJ
07093-5592
US
IV. Provider business mailing address
576 CENTRAL AVE STE 301
EAST ORANGE NJ
07018-1943
US
V. Phone/Fax
- Phone: 201-418-6800
- Fax:
- Phone: 973-678-5500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOSHE
ROSENBERG
Title or Position: OWNER
Credential:
Phone: 201-418-6800