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General NPI Number Information
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NPI Number | 1790083087
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Entity Type | Organization
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Legal Business Name | KABOF HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 225 N WOOD AVE STE 9
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City | LINDEN
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State | NJ
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Zip | 07036-4200
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Country | US
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Telephone | 908-486-0891
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Fax | 908-486-0963
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Provider Business Mailing Address
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Address Line | 225 N WOOD AVE STE 9
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City | LINDEN
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State | NJ
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Zip | 07036-4200
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Country | US
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Telephone | 908-486-0891
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Fax | 908-486-0963
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MRS. ABIMBOLA OLUFUNKE FAGUN
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Credential | RN
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Telephone | 908-486-0891
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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 | HPO152000
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License Number State | NJ
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