Organization
FAUNTIX SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMON MILLER (CEO/EXECUTIVE DIRECTOR)
(856) 278-9218
Entity
Organization
Contact information
Practice address
270 SUMMIT AVE APT 1, JERSEY CITY, NJ 07306-2666
(856) 278-9218
Mailing address
270 SUMMIT AVE APT 1, JERSEY CITY, NJ 07306-2666
(856) 278-9218
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538626684
—
NJ
Enumeration date
04/15/2019
Last updated
08/28/2020
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