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General NPI Number Information
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NPI Number | 1952389272
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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 | 01/06/2006
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 1-3 SAINT JOSEPH TER
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2611
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Country | US
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Telephone | 732-750-0077
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Fax | 732-634-1811
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Provider Business Mailing Address
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Address Line | 1-3 SAINT JOSEPH TERR
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2611
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Country | US
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Telephone | 732-750-0077
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Fax | 732-634-1811
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Authorized Official
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Title or Position | MDS COORDINATOR
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Name | TERESA GRADOWSKA
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Credential | RN
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Telephone | 732-750-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 061223
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License Number State | NJ
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