Provider Demographics
NPI:1407472905
Name:HEALTH SERVE, LLC
Entity Type:Organization
Organization Name:HEALTH SERVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, PMP
Authorized Official - Phone:732-309-7098
Mailing Address - Street 1:30 STABLE CT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5672
Mailing Address - Country:US
Mailing Address - Phone:732-309-7098
Mailing Address - Fax:
Practice Address - Street 1:375 N MAIN ST STE C4
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1476
Practice Address - Country:US
Practice Address - Phone:856-288-2878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ07249982Medicaid