Healthcare Provider Details

I. General information

NPI: 1306355904
Provider Name (Legal Business Name): NURSES 4 BETTER LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W 111TH ST
NEW YORK NY
10026-4198
US

IV. Provider business mailing address

PO BOX 825
NEPTUNE NJ
07754-0825
US

V. Phone/Fax

Practice location:
  • Phone: 732-829-1126
  • Fax:
Mailing address:
  • Phone: 833-446-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18PO5723
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR15049900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number574487
License Number StateNY

VIII. Authorized Official

Name: MS. DOLORES JONES
Title or Position: CEO
Credential: PHD CAN,MSCMHC,RN
Phone: 833-446-8773