1316177074 NPI number — IKHAYA WORLD, INC

Table of content: (NPI 1316177074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316177074 NPI number — IKHAYA WORLD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IKHAYA WORLD, INC
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:
D/B/A BRIGHTSTAR CARE; ALSO D/B/A BRIGHTSTAR HEALTHCARE
Provider Other Organization Name Type Code:
3
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:
1316177074
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 KINDERKAMACK ROAD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
EMERSON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-483-8490
Provider Business Mailing Address Fax Number:
201-735-2111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 KINDERKAMACK ROAD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
EMERSON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-483-8490
Provider Business Practice Location Address Fax Number:
201-735-2111
Provider Enumeration Date:
07/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PREZTUNIK
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PRESIDENT & OWNER
Authorized Official Telephone Number:
201-483-8490

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  HPO131500-HCSF;CTO37 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164W00000X , with the licence number: HPO131500-HCSF;CTO37 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X , with the licence number: HPO131500&CTO373900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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