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General NPI Number Information
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NPI Number | 1033383377
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Entity Type | Organization
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Legal Business Name | KNM HOME HEALTH CARE AGENCY, LLC
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 14 COTTONWOOD DR
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City | LUMBERTON
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State | NJ
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Zip | 08048-5240
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Country | US
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Telephone | 609-265-1000
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Fax | 609-265-9976
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Provider Business Mailing Address
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Address Line | PO BOX 484
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City | LUMBERTON
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State | NJ
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Zip | 08048-0484
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Country | US
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Telephone | 609-265-1000
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Fax | 609-265-9976
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ALISA L OGLESBY
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Credential |
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Telephone | 609-265-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HP0068700
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License Number State | NJ
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