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General NPI Number Information
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NPI Number | 1801294202
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Entity Type | Organization
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Legal Business Name | WENDY B LONG LLC
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 7 HILLARY TER
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1056
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Country | US
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Telephone | 973-900-4591
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Fax | 973-943-4455
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Provider Business Mailing Address
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Address Line | 7 HILLARY TER
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1056
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Country | US
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Telephone | 973-900-4591
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Fax | 973-943-4455
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. ROBERT N LONG
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Credential |
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Telephone | 973-900-4591
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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 | HP0143100
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License Number State | NJ
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