Healthcare Provider Details

I. General information

NPI: 1033745880
Provider Name (Legal Business Name): NURTURING HEARTS HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 TICE BLVD STE 300B
WOODCLIFF LAKE NJ
07677-7671
US

IV. Provider business mailing address

123 TICE BLVD STE G
WOODCLIFF LAKE NJ
07677-7670
US

V. Phone/Fax

Practice location:
  • Phone: 203-441-1000
  • Fax:
Mailing address:
  • Phone: 757-733-1000
  • Fax: 757-713-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GADDY LIGHTSTONE
Title or Position: OWNER
Credential:
Phone: 757-733-1000