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Organization
JONATHAN'S HAVEN LLC
Active
Organization
JONATHAN'S HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWENDOLYN MONANGAI BA, LPN, CALA, CDP. (EXECUTIVE DIRECTOR)
(973) 652-4541
Entity
Organization
Contact information
Practice address
42 EAGLE ROCK AVE, ROSELAND, NJ 07068-1445
(973) 652-4541
Mailing address
42 EAGLE ROCK AVE, ROSELAND, NJ 07068-1445
(973) 652-4541
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
NULL
177F00000X
Lodging Provider
—
NULL
251B00000X
Case Management Agency
Primary
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
343800000X
Secured Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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