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General NPI Number Information
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NPI Number | 1548418486
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Entity Type | Organization
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Legal Business Name | VISIONARY HEALTH CARE SERVICES, LLC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 1266 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1344
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Country | US
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Telephone | 973-270-0213
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Fax | 973-773-2722
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Provider Business Mailing Address
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Address Line | 1266 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1344
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Country | US
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Telephone | 973-270-0213
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Fax | 973-773-2722
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. FE E DOMPOR
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Credential | RN
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Telephone | 973-270-0213
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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 | HP0115000
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License Number State | NJ
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