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General NPI Number Information
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NPI Number | 1164118717
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Entity Type | Organization
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Legal Business Name | HEPHZIBAH HEALTHCARE SERVICES
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 340 W PASSAIC ST STE 1
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3019
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Country | US
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Telephone | 201-546-8969
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Fax |
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Provider Business Mailing Address
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Address Line | 340 W PASSAIC ST STE 1
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3019
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Country | US
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Telephone | 201-546-8969
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DINAH BOAMAH-NYARKO
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Credential |
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Telephone | 929-497-4240
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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 |
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License Number State |
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