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General NPI Number Information
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NPI Number | 1609095314
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Entity Type | Organization
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Legal Business Name | INTERIM HEALTHCARE OF SADDLE BROOK, INC.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15 5TH STREET
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City | SADDLE BROOK
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State | NJ
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Zip | 07663
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Country | US
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Telephone | 201-843-0190
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Fax | 201-843-3284
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Provider Business Mailing Address
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Address Line | 15 5TH STREET
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City | SADDLE BROOK
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State | NJ
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Zip | 07663
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Country | US
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Telephone | 201-843-0190
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Fax | 201-843-3284
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. MARK LEWANDOSKI
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Credential |
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Telephone | 201-843-0190
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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 | HP0011201
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License Number State | NJ
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