Organization
ENDEAVOR HOUSE NORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT YATES (CONTRACT MANAGER)
(877) 262-7803
Entity
Organization
Contact information
Practice address
206 BERGEN AVE, KEARNY, NJ 07032-3384
(877) 262-7803
Mailing address
206 BERGEN AVE, KEARNY, NJ 07032-3384
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/04/2022
Last updated
10/01/2024
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