Provider Demographics
NPI:1174112239
Name:PRUDENT HOME HEALTH CARE SERVICES INC.
Entity type:Organization
Organization Name:PRUDENT HOME HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUMESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-783-2096
Mailing Address - Street 1:151 W PASSAIC ST STE 42
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 W PASSAIC ST STE 42
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3105
Practice Address - Country:US
Practice Address - Phone:646-783-2096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health