Provider Demographics
NPI:1013717453
Name:AJ FAMILY LEGACY CORPORATION
Entity type:Organization
Organization Name:AJ FAMILY LEGACY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-229-2298
Mailing Address - Street 1:7915 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4137
Mailing Address - Country:US
Mailing Address - Phone:551-236-4344
Mailing Address - Fax:551-360-4048
Practice Address - Street 1:7915 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4137
Practice Address - Country:US
Practice Address - Phone:551-236-4344
Practice Address - Fax:551-360-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care