Provider Demographics
NPI:1326571506
Name:ST. MONICA HEALTHCARE AGENCY, LLC
Entity Type:Organization
Organization Name:ST. MONICA HEALTHCARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO, REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:BENEDICTA
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:AKPAHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-736-1383
Mailing Address - Street 1:20 PROSPECT PL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5608
Mailing Address - Country:US
Mailing Address - Phone:973-736-1383
Mailing Address - Fax:
Practice Address - Street 1:20 PROSPECT PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5608
Practice Address - Country:US
Practice Address - Phone:973-736-1383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0203300251E00000X, 251F00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care