Provider Demographics
NPI:1275193484
Name:HENLUCY HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:HENLUCY HEALTH SYSTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAPEMI
Authorized Official - Middle Name:O
Authorized Official - Last Name:OBOLANLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-930-6688
Mailing Address - Street 1:308 MLK DR
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4946
Mailing Address - Country:US
Mailing Address - Phone:862-930-6688
Mailing Address - Fax:862-930-6689
Practice Address - Street 1:308 MLK DR
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-4946
Practice Address - Country:US
Practice Address - Phone:862-930-6688
Practice Address - Fax:862-930-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services