Provider Demographics
NPI:1508444936
Name:BREATH OF FRESH NURSES LLC
Entity Type:Organization
Organization Name:BREATH OF FRESH NURSES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANIE
Authorized Official - Middle Name:RACQUEL
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-626-2274
Mailing Address - Street 1:28 VALLEY RD STE 1-148
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2709
Mailing Address - Country:US
Mailing Address - Phone:973-626-2274
Mailing Address - Fax:
Practice Address - Street 1:28 VALLEY RD STE 1-148
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2709
Practice Address - Country:US
Practice Address - Phone:973-626-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health