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General NPI Number Information
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NPI Number | 1619520780
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Entity Type | Organization
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Legal Business Name | BALANCED LIFE HOME CARE SERVICES
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 65 OLD HIGHWAY 22 STE 4
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City | CLINTON
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State | NJ
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Zip | 08809-1329
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Country | US
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Telephone | 908-627-4600
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Fax | 908-627-4602
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Provider Business Mailing Address
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Address Line | 65 OLD HIGHWAY 22 STE 4
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City | CLINTON
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State | NJ
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Zip | 08809-1329
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Country | US
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Telephone | 908-627-4600
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Fax | 908-627-4602
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Authorized Official
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Title or Position | MEMBER/PRESIDENT
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Name | DR. JENNIFER NGOZI EMEJULU
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Credential | DPT
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Telephone | 908-627-4600
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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 |
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License Number State |
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