Organization
BELOVED CARE HOME AGENCY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE KETTY VICTOR GEORGES (CERTIFIED SENIOR CARE MANAGER)
(862) 224-4957
Entity
Organization
Contact information
Practice address
175 N PARK ST, EAST ORANGE, NJ 07017-1893
(973) 381-8590
(973) 928-8502
Mailing address
61 VALLEY WAY, WEST ORANGE, NJ 07052-5829
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP0312500
NJ STATE LICENSE
NJ
Enumeration date
04/13/2021
Last updated
04/13/2021
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