Organization
DEVELOPMENTAL DISABILITY AWARENESS WITH LOVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYQUAN L. GRIFFIN (EXECUTIVE DIRECTOR)
(973) 223-5197
Entity
Organization
Contact information
Practice address
334 W MAIN ST, BOONTON, NJ 07005-1148
(973) 588-5370
Mailing address
338 W MAIN ST, BOONTON, NJ 07005-1148
(973) 588-5370
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
06/26/2024
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