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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LIAKISA MONET HODGES (EXECUTIVE DIRECTOR)
(862) 215-2361
Entity
Organization

Contact information

Practice address
161 HARPER AVE APT 3, IRVINGTON, NJ 07111-1742
(862) 215-2361
Mailing address
PO BOX 132, ORANGE, NJ 07051-0132
(862) 215-2361

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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