Provider Demographics
NPI:1750649406
Name:ARDENT HOME HEALTHCARE
Entity Type:Organization
Organization Name:ARDENT HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNMILAYO
Authorized Official - Middle Name:A
Authorized Official - Last Name:AIYEGBO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:973-200-8370
Mailing Address - Street 1:150 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3813
Mailing Address - Country:US
Mailing Address - Phone:973-200-8370
Mailing Address - Fax:973-200-8370
Practice Address - Street 1:150 WALKER RD
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3813
Practice Address - Country:US
Practice Address - Phone:973-200-8370
Practice Address - Fax:973-200-8370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0154400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health