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General NPI Number Information
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NPI Number | 1316657174
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Entity Type | Organization
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Legal Business Name | AHAVAH HOME LLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 336 WILLETT AVE
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City | RIVERSIDE
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State | RI
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Zip | 02915-2511
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Country | US
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Telephone | 401-437-0336
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Fax |
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Provider Business Mailing Address
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Address Line | 36 ORANGEBURGH RD
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7443
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Country | US
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Telephone | 863-595-7353
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MS. PIER GASMENA
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Credential |
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Telephone | 863-595-7353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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