Provider Demographics
NPI:1790659464
Name:SHS CENTRAL BERGEN LLC
Entity type:Organization
Organization Name:SHS CENTRAL BERGEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-490-9881
Mailing Address - Street 1:2 UNIVERSITY PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6210
Mailing Address - Country:US
Mailing Address - Phone:201-255-0048
Mailing Address - Fax:
Practice Address - Street 1:2 UNIVERSITY PLZ
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6202
Practice Address - Country:US
Practice Address - Phone:201-255-0048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care