Provider Demographics
NPI:1417010950
Name:VISITING NURSE ASSOCIATION OF NORTHERN NEW JERSEY, INC
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF NORTHERN NEW JERSEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-539-1216
Mailing Address - Street 1:175 SOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-539-1216
Mailing Address - Fax:973-539-9802
Practice Address - Street 1:175 SOUTH STREET
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-539-1216
Practice Address - Fax:973-539-9802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ71401251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3687317Medicaid