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General NPI Number Information
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NPI Number | 1851863344
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Entity Type | Organization
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Legal Business Name | LITTLE SERVANT SISTERS - ST. JOSEPH'S HOME ASSISTED LIVING AND NURSING
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 1 SAINT JOSEPH TER
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2648
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Country | US
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Telephone | 732-634-0004
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Fax | 732-634-4586
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Provider Business Mailing Address
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Address Line | 1 SAINT JOSEPH TER
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2648
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Country | US
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Telephone | 732-634-0004
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Fax | 732-634-4586
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ZDZISLAWA KRUKOWSKA
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Credential | LNHA, NJCALA
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Telephone | 734-634-0004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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