Organization
CORE SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA TRUEHEART (ADMINISTRATOR)
(716) 622-4370
Entity
Organization
Contact information
Practice address
221 BROADMOOR CT UNIT 6, UNION, NJ 07083-8757
(716) 622-4370
Mailing address
221 BROADMOOR CT UNIT 6, UNION, NJ 07083-8757
(716) 622-4370
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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