Provider Demographics
NPI:1609343912
Name:VISITING NURSE ASSOCIATION OF CENTRAL JERSEY, COMMUNITY HEALTH CENTER,
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF CENTRAL JERSEY, COMMUNITY HEALTH CENTER,
Other - Org Name:FREEHOLD FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-502-5144
Mailing Address - Street 1:806 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5363
Mailing Address - Country:US
Mailing Address - Phone:732-502-5144
Mailing Address - Fax:732-264-0799
Practice Address - Street 1:597 PARK AVE STE B
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2590
Practice Address - Country:US
Practice Address - Phone:732-294-2540
Practice Address - Fax:732-294-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)