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Organization

BEDROCK AT HOME NEW JERSEY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS BANAR (DIRECTOR OF OPERATIONS)
(856) 874-7800
Entity
Organization

Contact information

Practice address
1 HOLTEC DR STE 203, MARLTON, NJ 08053-3402
(856) 874-7800
(908) 955-9419
Mailing address
1 HOLTEC DR STE 203, MARLTON, NJ 08053-3402
(856) 874-7800
(908) 955-9419

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
253Z00000X
In Home Supportive Care Agency
Primary
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Enumeration date
03/01/2023
Last updated
02/27/2024
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