Organization
SSP HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IYEN STACEY IGHODARO DNP, APRN, FNP-C (OWNER)
(646) 633-1525
Entity
Organization
Contact information
Practice address
197 HILLSIDE AVE, LIVINGSTON, NJ 07039-3648
(646) 633-1525
Mailing address
197 HILLSIDE AVE, LIVINGSTON, NJ 07039-3648
(646) 633-1525
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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