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General NPI Number Information
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NPI Number | 1306699160
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Entity Type | Organization
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Legal Business Name | EMPIRE SUPPORT SERVICES
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 1801 STALLION CT
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-8745
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Country | US
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Telephone | 609-916-9734
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Fax | 856-481-6384
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Provider Business Mailing Address
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Address Line | 1801 STALLION CT
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-8745
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Country | US
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Telephone | 609-916-9734
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Fax | 856-481-6384
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Authorized Official
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Title or Position | CEO
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Name | REMI J ETOKHANA
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Credential | OWNER
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Telephone | 609-916-9734
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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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