Organization
MADONA FAMILY SUPPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMEKA VICTOR OKORIE R.N (B.S.N) (CEO)
(856) 728-0781
Entity
Organization
Contact information
Practice address
119 HARMONY CIRCLE RD, SICKLERVILLE, NJ 08081-5635
(856) 728-0781
(856) 728-0781
Mailing address
119 HARMONY CIRCLE RD, SICKLERVILLE, NJ 08081-5635
(856) 728-0781
(856) 728-0781
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
02/10/2010
Last updated
02/10/2010
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