Provider Demographics
NPI:1952734279
Name:HEALTHY HABITATS, LLC
Entity Type:Organization
Organization Name:HEALTHY HABITATS, LLC
Other - Org Name:POONAM SOOKNANAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POONAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOKNANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-978-7224
Mailing Address - Street 1:23 GODFREY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1350
Mailing Address - Country:US
Mailing Address - Phone:201-978-7224
Mailing Address - Fax:
Practice Address - Street 1:23 GODFREY AVE
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1350
Practice Address - Country:US
Practice Address - Phone:201-978-7224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-11
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00929300251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health