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Individual

SOPHIA KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
587 CENTRAL AVE # 304, NEWARK, NJ 07107-1019
(862) 367-2461
Mailing address
587 CENTRAL AVE # 304, NEWARK, NJ 07107-1019
(862) 367-2461

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
253Z00000X
In Home Supportive Care Agency
Primary
372600000X
Adult Companion
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
08/05/2024
Last updated
08/05/2024
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