The Well Balanced Senior Program
Community Health Worker in East Orange, New Jersey
1457515207- Practice location
- 111 South Munn Ave, Suite 2A, East Orange, NJ 07018
- Phone
- 908-296-5258
- Fax
- 973-732-0460
- Last updated
- November 23, 2009
The Well Balanced Senior Program is a healthcare organization based in East Orange, NJ. The Well Balanced Senior Program practices in East Orange, NJ. The NPI Number for The Well Balanced Senior Program is 1457515207 and holds a License No. HP0135400 (NJ). The current practice location address for The Well Balanced Senior Program is 111 South Munn Ave, Suite 2A, East Orange, NJ 07018 and can be reached out via phone at 908-296-5258 and via fax at 973-732-0460.
Provider Profile Details
- NPI Number
- 1457515207
- Provider Name
- The Well Balanced Senior Program
- Provider Entity Type
- Organization
- Address
- 111 South Munn Ave, Suite 2A, East Orange, NJ 07018
- Phone Number
- 908-296-5258
- Fax Number
- 973-732-0460
- Primary Taxonomy
- Community Health Worker · 172V00000X
- Organization Subpart
- No
- Authorized Official
- Shelly Denise Larkins · Executive Director · 908-296-5258
- Provider Enumeration Date
- July 10, 2008
- Last Update Date
- November 23, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 111 South Munn Ave
Suite 2A
East Orange, NJ 07018 - City
- East Orange
- State
- New Jersey
- Zip
- 07018
- Phone Number
- 908-296-5258
- Fax Number
- 973-732-0460
Provider Business Mailing Address Details
- Address
- 111 South Munn Ave
Suite 2A
East Orange, NJ 07018 - City
- East Orange
- State
- NJ
- Zip
- 07018
- Phone Number
- 908-296-5258
- Fax Number
- 973-732-0460
License Information
- License Number (1)
- HP0135400
- License State (1)
- NJ
- Taxonomy (1)
- Home Health · 251E00000X
- License Number (2)
- 0400239766
- License State (2)
- NJ
- Taxonomy (2)
- Clinic/Center, Community Health · 261QC1500X
- License Number (3)
- 0400239766
- License State (3)
- NJ
- Taxonomy (3)
- Community Health Worker · 172V00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of The Well Balanced Senior Program?
The NPI number of The Well Balanced Senior Program is 1457515207. It was assigned on July 10, 2008 and is currently active in the NPPES registry.
What is the specialty of The Well Balanced Senior Program?
The Well Balanced Senior Program is registered under the primary taxonomy Community Health Worker (code 172V00000X), licensed in NJ under license number HP0135400.
Where does The Well Balanced Senior Program practice?
The practice location is 111 South Munn Ave, Suite 2A, East Orange, NJ 07018. The office can be reached at 908-296-5258 (phone) or 973-732-0460 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1457515207 directly on the NPPES registry website.