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General NPI Number Information
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NPI Number | 1699100479
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Entity Type | Organization
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Legal Business Name | OUR LITTLE HILL, LLC
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 140 DARRAH LN
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3110
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Country | US
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Telephone | 609-883-8188
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Fax | 609-883-8199
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Provider Business Mailing Address
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Address Line | 140 DARRAH LN
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3110
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Country | US
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Telephone | 609-883-8188
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Fax | 609-883-8199
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | RUDOLF TERVOOREN
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Credential |
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Telephone | 609-883-8188
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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 | HP0107200
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License Number State | NJ
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