Organization
FAMILY REBUILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANANEIKA MIDEA GORDON (FOUNDER)
(561) 633-7761
Entity
Organization
Contact information
Practice address
811 MORGAN AVE, PALMYRA, NJ 08065-1933
(732) 379-1663
Mailing address
811 MORGAN AVE, PALMYRA, NJ 08065-1933
(732) 379-1663
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
332U00000X
Home Delivered Meals
—
—
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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