Organization
FOUR CORNERS COMMUNITY SERVICES LLC
Active
Parent organization
FOUR CORNERS COMMUNITY SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUR CORNERS COMMUNITY SERVICES LLC
Authorized official
MISS AMA J BAFFOE (EXECUTIVE DIRECTOR)
(973) 210-6066
Entity
Organization
Contact information
Practice address
201 19TH ST FL 1, UNION CITY, NJ 07087-5439
(973) 210-6066
Mailing address
209 PASSAIC AVE, BELLEVILLE, NJ 07109-1960
(973) 392-0430
(973) 436-4714
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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