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General NPI Number Information
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NPI Number | 1699712166
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Entity Type | Organization
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Legal Business Name | VISITING NURSE ASSOCIATION OF CENTRAL JERSEY COMMUNITY HEALTH CENTER I
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 64-66 BRIDGE AVENUE
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City | RED BANK
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State | NJ
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Zip | 07701
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Country | US
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Telephone | 732-219-6620
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Fax | 732-219-6625
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Provider Business Mailing Address
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Address Line | 806 5TH AVE
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City | ASBURY PARK
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State | NJ
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Zip | 07712-5363
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Country | US
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Telephone | 732-502-5144
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Fax | 732-264-0799
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Authorized Official
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Title or Position | SCHEDULING & CREDENTIALING
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Name | MS. DARLENE RICE
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Credential |
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Telephone | 732-502-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 23983
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License Number State | NJ
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