Organization
MULTIPLE PERSPECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LA TARISHS FOUNTAIN MSW (EXECUTIVE DIRECTOR)
(908) 875-5312
Entity
Organization
Contact information
Practice address
726 GREEN LN, UNION, NJ 07083-7766
(908) 527-0273
Mailing address
726 GREEN LN, UNION, NJ 07083-7766
(908) 527-0273
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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