Provider Demographics
NPI:1396299566
Name:HOSPICE OF SOUTHERN NEW JERSEY, INC.
Entity type:Organization
Organization Name:HOSPICE OF SOUTHERN NEW JERSEY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-679-2270
Mailing Address - Street 1:1100 LAUREL OAK RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4363
Mailing Address - Country:US
Mailing Address - Phone:856-661-2073
Mailing Address - Fax:856-661-2093
Practice Address - Street 1:1100 LAUREL OAK RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4363
Practice Address - Country:US
Practice Address - Phone:856-661-2073
Practice Address - Fax:856-661-2093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based