Healthcare Provider Details

I. General information

NPI: 1952463044
Provider Name (Legal Business Name): DAUGHTERS OF ISRAEL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052
US

IV. Provider business mailing address

1155 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052
US

V. Phone/Fax

Practice location:
  • Phone: 973-731-5100
  • Fax: 973-731-0280
Mailing address:
  • Phone: 973-731-5100
  • Fax: 973-731-0280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number030703
License Number StateNJ

VIII. Authorized Official

Name: MS. SUSAN GROSSER
Title or Position: EXECUTIVE DIRECTOR
Credential: LNHA
Phone: 973-400-3301