Organization
FAIRLAWNBRIGHTSTAR
Active
Other names
Brightstar Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY BOSTELAAR (AGENCY MANAGER)
(862) 257-9804
Entity
Organization
Contact information
Practice address
470 CHAMBERLAIN AVE, #5, PATERSON, NJ 07522-1031
(862) 257-9804
(973) 341-7088
Mailing address
470 CHAMBERLAIN AVE, #5, PATERSON, NJ 07522-1031
(862) 257-9804
(973) 341-7088
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251E0000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251E0000X
HOMEHEALTH
NJ
Enumeration date
09/22/2014
Last updated
09/22/2014
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