# LAURA FONVILLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134626591
- **Authorized official:** LAURA ANGELA FONVILLE (DIRECTOR)
- **Authorized official phone:** (609) 594-7726

## Contact information

- **Practice address:** 218 PINE AVE, EGG HARBOR TOWNSHIP, NJ 08234-5339
- **Practice address phone:** (609) 594-7726
- **Mailing address:** 218 PINE AVE, EGG HARBOR TOWNSHIP, NJ 08234-5339
- **Mailing address phone:** (609) 594-7726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2018
- **Last updated:** 04/11/2018