Organization
RIDGEWOOD NURSING HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK HAVLICEK (REGISTERED NURSE)
(201) 739-7671
Entity
Organization
Contact information
Practice address
11 ZIMMER AVE, MIDLAND PARK, NJ 07432-1121
(201) 739-7671
Mailing address
11 ZIMMER AVE, MIDLAND PARK, NJ 07432-1121
(201) 739-7671
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26N011880500
NJ
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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