Organization
ST MARK HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAFIK FAKHOURI MR (PRESIDENT)
(201) 424-4847
Entity
Organization
Contact information
Practice address
895 BERGEN AVE, 307, JERSEY CITY, NJ 07306-4309
(201) 424-4847
(201) 758-7778
Mailing address
895 BERGEN AVE, 307, JERSEY CITY, NJ 07306-4309
(201) 424-4847
(201) 758-7778
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HP0175700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP017500
LICENSE
NJ
Enumeration date
01/06/2016
Last updated
01/06/2016
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