Organization
HOME HERITAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABAYOMI OLUSOLA OKUNNUBI (CEO)
(908) 917-1285
Entity
Organization
Contact information
Practice address
76 E WESTFIELD AVE APT 10, ROSELLE PARK, NJ 07204-2237
(908) 917-1285
Mailing address
76 E WESTFIELD AVE APT 10, ROSELLE PARK, NJ 07204-2237
(908) 917-1285
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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