Provider Demographics
NPI:1467099416
Name:DOVE HOSPICE SERVICES OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:DOVE HOSPICE SERVICES OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BERTELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-405-3035
Mailing Address - Street 1:198 ROUTE 9 NORTH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3073
Mailing Address - Country:US
Mailing Address - Phone:732-405-3035
Mailing Address - Fax:732-405-3055
Practice Address - Street 1:198 ROUTE 9 NORTH
Practice Address - Street 2:SUITE 200
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1383
Practice Address - Country:US
Practice Address - Phone:732-405-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0775983Medicaid