Provider Demographics
NPI:1073724134
Name:ST. JOSEPH'S REST HOME FOR AGED WOMEN
Entity Type:Organization
Organization Name:ST. JOSEPH'S REST HOME FOR AGED WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SR. JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDERUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-956-1921
Mailing Address - Street 1:46 PREAKNESS AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07522-1420
Mailing Address - Country:US
Mailing Address - Phone:973-956-1921
Mailing Address - Fax:073-956-1582
Practice Address - Street 1:46 PREAKNESS AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1420
Practice Address - Country:US
Practice Address - Phone:973-956-1921
Practice Address - Fax:073-956-1582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1608-0234313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility