Provider Demographics
NPI:1285208801
Name:SERVELINK
Entity Type:Organization
Organization Name:SERVELINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNICIOUS
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-682-4618
Mailing Address - Street 1:1012 PARK ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08518-1010
Mailing Address - Country:US
Mailing Address - Phone:909-682-4618
Mailing Address - Fax:
Practice Address - Street 1:1012 PARK ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-1010
Practice Address - Country:US
Practice Address - Phone:909-682-4618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care