Provider Demographics
NPI:1558071613
Name:MARVELLOUS HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:MARVELLOUS HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOKANMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-404-1746
Mailing Address - Street 1:1673 BRACKEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094
Mailing Address - Country:US
Mailing Address - Phone:646-404-1746
Mailing Address - Fax:
Practice Address - Street 1:1673 BRACKEN DRIVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094
Practice Address - Country:US
Practice Address - Phone:646-404-1746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home