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Organization
KULEA LYFE LLC
Active
Organization
KULEA LYFE LLC
Active
Other names
TAJ HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
TERRIN MONNEY LPN (NURSE)
(732) 822-0786
Entity
Organization
Contact information
Practice address
907 WEXFORD CT, EDGEWATER PARK, NJ 08010-3581
(723) 822-0786
Mailing address
907 WEXFORD CT, EDGEWATER PARK, NJ 08010-3581
(723) 822-0786
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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