Provider Demographics
NPI:1437506854
Name:B&G HOMECARE INC.
Entity Type:Organization
Organization Name:B&G HOMECARE INC.
Other - Org Name:GRISWOLD HOME CARE BERGEN COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:BERREBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-489-0006
Mailing Address - Street 1:4 BANTA PL
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5620
Mailing Address - Country:US
Mailing Address - Phone:201-489-0006
Mailing Address - Fax:201-489-0063
Practice Address - Street 1:4 BANTA PL
Practice Address - Street 2:SUITE 5
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5620
Practice Address - Country:US
Practice Address - Phone:201-489-0006
Practice Address - Fax:201-489-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0747317302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization