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Organization
PRIME LUXURY HAVEN
Active
Organization
PRIME LUXURY HAVEN
Active
Other names
Prime Luxury Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKIN OBISESAN (DIRECTOR)
(718) 925-7080
Entity
Organization
Contact information
Practice address
18 2ND ST, NEWARK, NJ 07107-4429
(718) 925-7080
Mailing address
18 2ND ST, NEWARK, NJ 07107-4429
(718) 925-7080
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
NULL
261QA0600X
Adult Day Care Clinic/Center
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
310400000X
Assisted Living Facility
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NULL
311Z00000X
Custodial Care Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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