Provider Demographics
NPI:1568818656
Name:HENLUCY HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:HENLUCY HEALTH SYSTEM LLC
Other - Org Name:HENLUCY HEALTH SYSTEM LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLAPEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OBOLANLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-930-6688
Mailing Address - Street 1:68 GARSIDE ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1006
Mailing Address - Country:US
Mailing Address - Phone:862-930-6688
Mailing Address - Fax:862-930-6689
Practice Address - Street 1:68 GARSIDE ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1006
Practice Address - Country:US
Practice Address - Phone:862-930-6688
Practice Address - Fax:862-930-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No331L00000XSuppliersBlood Bank
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child