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General NPI Number Information
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NPI Number | 1467589978
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Entity Type | Organization
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Legal Business Name | LITTLE SISTERS OF THE POOR ST JOSEPHS HOME FOR THE ELDERLY
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 140 SHEPHERD LN
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City | TOTOWA
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State | NJ
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Zip | 07512-2188
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Country | US
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Telephone | 973-942-0300
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Fax | 973-942-7201
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Provider Business Mailing Address
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Address Line | 140 SHEPHERD LN
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City | TOTOWA
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State | NJ
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Zip | 07512-2188
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Country | US
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Telephone | 973-942-0300
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Fax | 973-942-7201
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GERARD MARIE OCONNOR
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Credential | LSP
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Telephone | 973-942-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 703330
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License Number State | NJ
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