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General NPI Number Information
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NPI Number | 1265560247
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Entity Type | Organization
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Legal Business Name | GENTLE HEART CARE, LLC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 333 SYLVAN AVE STE 205
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2724
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Country | US
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Telephone | 201-613-6173
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Fax | 201-621-5052
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Provider Business Mailing Address
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Address Line | 333 SYLVAN AVE STE 205
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2724
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Country | US
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Telephone | 201-613-6173
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Fax | 201-621-5052
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAE SONG
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Credential |
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Telephone | 201-613-6173
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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 | HP0081200
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License Number State | NJ
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