Individual
LOURDES AYUSTE FREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 PARK AVE, MINE HILL, NJ 07803-3128
(973) 462-2626
Mailing address
5 PARK AVE, MINE HILL, NJ 07803-3128
(973) 462-2626
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NJ
Other
Enumeration date
03/02/2026
Last updated
03/10/2026
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