# OLYMPIC GROUP HOME AND HOMECARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164766507
- **Authorized official:** MRS. GRACE K NYATOME ME.D (MANAGER)
- **Authorized official phone:** (201) 522-6526

## Contact information

- **Practice address:** 105 WOODLAND ROAD, BLOOMFIELD, NJ 07003
- **Practice address phone:** (201) 522-6526
- **Mailing address:** 105 WOODLAND RD, BLOOMFIELD, NJ 07003-5201
- **Mailing address phone:** (201) 522-6526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | 0400510330 | NJ | Yes |

## Other

- **Enumeration date:** 11/26/2012
- **Last updated:** 11/26/2012