Organization
BEBOLD AND BE FREE & UNIQUE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE SHANTE JOHNSON (OWNER)
(201) 844-2310
Entity
Organization
Contact information
Practice address
10 GREEN ST APT 218, WOODBRIDGE, NJ 07095-3364
(201) 844-2310
Mailing address
10 GREEN ST APT 218, WOODBRIDGE, NJ 07095-3364
(201) 844-2310
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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