Organization
METAMORPHOSIS TRANSITIONAL LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. MARETTA LAJAUNE HODGES ED.M., MSW (EXECUTIVE DIRECTOR)
(201) 255-7348
Entity
Organization
Contact information
Practice address
241 HUDSON ST STE 133, HACKENSACK, NJ 07601-6708
(201) 255-7348
(201) 255-7352
Mailing address
100 SELVAGE AVE, TEANECK, NJ 07666-4819
(201) 255-7348
(201) 255-7352
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H60825187351722
NJ DRIVERS LICENSE
NJ
Enumeration date
01/05/2022
Last updated
01/05/2022
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