Provider Demographics
NPI:1629121306
Name:WANDA BEST HEALTH CARE, INC
Entity Type:Organization
Organization Name:WANDA BEST HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAULK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-245-1700
Mailing Address - Street 1:108 CHESTNUT ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2583
Mailing Address - Country:US
Mailing Address - Phone:908-245-1700
Mailing Address - Fax:908-245-2569
Practice Address - Street 1:108 CHESTNUT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-2583
Practice Address - Country:US
Practice Address - Phone:908-245-1700
Practice Address - Fax:908-245-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0219500251E00000X
NJHP0219501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7989008Medicaid