Organization
ROSELAND DEVELOPMENT AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARSHA LEWIS (CEO)
(404) 579-6261
Entity
Organization
Contact information
Practice address
126 RANDOLPH AVE APT 1R, JERSEY CITY, NJ 07305-4451
(404) 579-6261
Mailing address
126 RANDOLPH AVE APT 1R, JERSEY CITY, NJ 07305-4451
(404) 579-6261
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347E00000X
Transportation Broker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/29/2022
Last updated
04/27/2022
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