Organization
BREATH OF LIFE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGARDO LIONEL FERNANDEZ LCADC (DIRECTOR)
(732) 690-4616
Entity
Organization
Contact information
Practice address
107 CEDAR GROVE LN STE 103E, SOMERSET, NJ 08873-4719
(732) 690-4616
(732) 805-0303
Mailing address
107 CEDAR GROVE LN STE 103E, SOMERSET, NJ 08873-4719
(732) 690-4616
(732) 805-0303
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
37LC00162000
NJ
Other
Enumeration date
07/28/2013
Last updated
07/28/2013
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