1306169099 NPI number — FRIENDSHIP HOME SOLUTIONS OF NEW JERSEY

Table of content: (NPI 1306169099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306169099 NPI number — FRIENDSHIP HOME SOLUTIONS OF NEW JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIENDSHIP HOME SOLUTIONS OF NEW JERSEY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306169099
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 PLUS PARK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-365-4424
Provider Business Mailing Address Fax Number:
615-365-0998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1440 HOW LN STE 2A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08902-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-626-5095
Provider Business Practice Location Address Fax Number:
732-626-1511
Provider Enumeration Date:
03/09/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PLANTINGA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-365-4424

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HP0111700 . This is a "LICENCE #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".