Provider Demographics
NPI:1164118717
Name:HEPHZIBAH HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:HEPHZIBAH HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DINAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAMAH-NYARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-497-4240
Mailing Address - Street 1:340 W PASSAIC ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3019
Mailing Address - Country:US
Mailing Address - Phone:201-546-8969
Mailing Address - Fax:
Practice Address - Street 1:340 W PASSAIC ST STE 1
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3019
Practice Address - Country:US
Practice Address - Phone:201-546-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health