Individual
MR. MUKHTAR FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
156 HEMPSTEAD DR, SOMERSET, NJ 08873-3948
(732) 485-3959
Mailing address
156 HEMPSTEAD DR, SOMERSET, NJ 08873-3948
(732) 485-3959
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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