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General NPI Number Information
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NPI Number | 1184284416
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Entity Type | Organization
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Legal Business Name | BL CORE HEALTH CLINIC INC
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 401 HOWE AVE APT A9
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City | PASSAIC
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State | NJ
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Zip | 07055-1925
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Country | US
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Telephone | 973-473-7200
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Fax | 973-472-7300
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Provider Business Mailing Address
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Address Line | 401 HOWE AVE APT A9
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City | PASSAIC
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State | NJ
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Zip | 07055-1925
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Country | US
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Telephone | 973-473-7200
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Fax | 973-472-7300
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Authorized Official
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Title or Position | MANAGEMENT
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Name | SONIA L ESQUIVEL
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Credential |
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Telephone | 201-397-4882
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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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