Provider Demographics
NPI:1174520076
Name:VNA HEALTH GROUP OF NEW JERSEY, LLC
Entity type:Organization
Organization Name:VNA HEALTH GROUP OF NEW JERSEY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYLORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-862-3330
Mailing Address - Street 1:23 MAIN STREET
Mailing Address - Street 2:SUITE D1
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2136
Mailing Address - Country:US
Mailing Address - Phone:732-224-6914
Mailing Address - Fax:732-784-9710
Practice Address - Street 1:80 MAIN STREET - SUITE 300
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4850
Practice Address - Country:US
Practice Address - Phone:973-243-9666
Practice Address - Fax:732-784-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22714,24416,22634251G00000X
NJ24416251G00000X
NJ22634251G00000X
NJ22714251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0557153Medicaid
0L0684OtherHEALTH NET
13615OtherUNIVERSITY HEALTH PLAN
NJ22634OtherHOSPICE LICENSES
8426225OtherAETNA/USHC
F07459OtherCCS
1014126OtherHORIZON/NJ HEALTH
NJ22714OtherHOSPICE LICENSES
ANC709OtherOXFORD HEALTH
004218OtherAMERIHEALTH
0042545OtherAETNA/USHC
NJ24416OtherHOSPICE LICENSES
88760OtherAMERIGROUP