Organization
BROADWAY RESPITE AND HOME CARE, LLC
Active
Other names
Broadway Respite and Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZHANNA BASINA RN (PRESIDENT)
(201) 703-3980
Entity
Organization
Contact information
Practice address
24-20 BROADWAY, FAIR LAWN, NJ 07410-2055
(201) 703-3980
(201) 703-3984
Mailing address
24-20 BROADWAY, FAIR LAWN, NJ 07410-2055
(201) 703-3980
(201) 703-3984
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
HP0100300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0519049
—
NJ
Enumeration date
10/25/2016
Last updated
10/25/2016
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