Organization
FAMILY INNOVATION AND CONSULTATION
Active
Organization
FAMILY INNOVATION AND CONSULTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCHAUNE DAYDREA GAMBLE LSW (SOCIAL WORKER)
(917) 288-1100
Entity
Organization
Contact information
Practice address
569 DR MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-1247
(917) 288-1100
Mailing address
475 RIDGE ST, NEWARK, NJ 07104-1423
(917) 288-1100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SL05689700
NJ
Other
Enumeration date
12/10/2017
Last updated
03/21/2025
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