Organization
AVENUES TO INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN C CLARK (EXECUTIVE DIRECTOR)
(856) 537-7919
Entity
Organization
Contact information
Practice address
304 S BROAD ST, WOODBURY, NJ 08096-2404
(856) 537-7919
Mailing address
304 S BROAD ST, WOODBURY, NJ 08096-2404
(856) 537-7919
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NJ
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
NJ
251X00000X
Supports Brokerage Agency
—
NJ
253Z00000X
In Home Supportive Care Agency
—
NJ
Other
Enumeration date
12/12/2012
Last updated
06/25/2020
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