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Organization
ANGELIC ADVANCE SUPPORT COORDINATOR
Active
Organization
ANGELIC ADVANCE SUPPORT COORDINATOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEEMA JOHN MUSHI (CEO)
(319) 300-0095
Entity
Organization
Contact information
Practice address
399 2ND ST APT 3R, JERSEY CITY, NJ 07302-2248
(319) 300-0095
Mailing address
1107 CAMERON RD, EFFORT, PA 18330-2301
(319) 464-1188
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
11/20/2023
Last updated
12/03/2023
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