Organization
ELDERLY MIND AND SPIRTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MONIQUE SIERRA DAVIS (GENERAL PARTNER)
(973) 847-1526
Entity
Organization
Contact information
Practice address
147 FAIRMOUNT AVE FL 1, NEWARK, NJ 07103-2432
(908) 486-0337
Mailing address
147 FAIRMOUNT AVE FL 1, NEWARK, NJ 07103-2432
(973) 486-0337
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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