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General NPI Number Information
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NPI Number | 1558071613
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Entity Type | Organization
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Legal Business Name | MARVELLOUS HEALTH CARE SERVICES
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 1673 BRACKEN DRIVE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094
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Country | US
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Telephone | 646-404-1746
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Fax |
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Provider Business Mailing Address
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Address Line | 1673 BRACKEN DRIVE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094
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Country | US
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Telephone | 646-404-1746
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GRACE NJOKANMA
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Credential |
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Telephone | 646-404-1746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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