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General NPI Number Information
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NPI Number | 1669697280
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Entity Type | Organization
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Legal Business Name | ELDERCARE OF ELIZABETH
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 550 N BROAD ST
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City | ELIZABETH
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State | NJ
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Zip | 07208-3302
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Country | US
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Telephone | 908-994-0050
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Fax | 908-994-0056
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Provider Business Mailing Address
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Address Line | 550 N BROAD ST
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City | ELIZABETH
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State | NJ
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Zip | 07208-3302
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Country | US
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Telephone | 908-994-0050
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Fax | 908-994-0056
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HAROLD C. HERSKOWITZ
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Credential | LNHA
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Telephone | 908-994-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 908116
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License Number State | NJ
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