Provider Demographics
NPI:1851863344
Name:LITTLE SERVANT SISTERS - ST. JOSEPH'S HOME ASSISTED LIVING AND NURSING
Entity Type:Organization
Organization Name:LITTLE SERVANT SISTERS - ST. JOSEPH'S HOME ASSISTED LIVING AND NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZDZISLAWA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUKOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA, NJCALA
Authorized Official - Phone:734-634-0004
Mailing Address - Street 1:1 SAINT JOSEPH TER
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2648
Mailing Address - Country:US
Mailing Address - Phone:732-634-0004
Mailing Address - Fax:732-634-4586
Practice Address - Street 1:1 SAINT JOSEPH TER
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2648
Practice Address - Country:US
Practice Address - Phone:732-634-0004
Practice Address - Fax:732-634-4586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE SERVANT SISTERS - SAINT JOSEPH'S HOME ASSISTED LIVING & NURSING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility