Provider Demographics
NPI:1467900720
Name:BKT HIGH QUALITY HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:BKT HIGH QUALITY HEALTHCARE AGENCY
Other - Org Name:DIGNITY NURSING & STAFFING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/ CO FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KYWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:856-451-5908
Mailing Address - Street 1:6 S LAUREL ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1945
Mailing Address - Country:US
Mailing Address - Phone:856-451-5908
Mailing Address - Fax:856-455-8766
Practice Address - Street 1:6 S LAUREL ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1945
Practice Address - Country:US
Practice Address - Phone:856-451-5908
Practice Address - Fax:856-455-8766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0220200OtherNJ CONSUMER AFFAIR
NJ0513369Medicaid