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General NPI Number Information
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NPI Number | 1629635628
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Entity Type | Organization
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Legal Business Name | THE SENIOR NJ, LLC
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Dates
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Enumeration Date | 05/24/2019
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 434 UNION BLVD
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City | TOTOWA
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State | NJ
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Zip | 07512-2562
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Country | US
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Telephone | 201-355-5209
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Fax | 862-257-3998
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Provider Business Mailing Address
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Address Line | 434 UNION BLVD
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City | TOTOWA
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State | NJ
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Zip | 07512-2562
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Country | US
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Telephone | 201-355-5209
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Fax | 862-257-3998
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CAITLIN WALLEN
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Credential |
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Telephone | 201-355-5209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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