Organization
ENCHANTED IMPRESSIONS
Active
Organization
ENCHANTED IMPRESSIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYANA DANIELLE WHITING (ADMINISTRATIVE DIRECTOR)
(973) 634-0236
Entity
Organization
Contact information
Practice address
440 DIETZ ST, ROSELLE, NJ 07203-2328
(973) 634-0236
Mailing address
440 DIETZ ST, ROSELLE, NJ 07203-2328
(973) 634-0236
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/11/2025
Last updated
04/17/2025
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