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Organization

FOUR CORNERS COMMUNITY SERVICES LLC

Active
Parent organization
FOUR CORNERS COMMUNITY SERVICES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
FOUR CORNERS COMMUNITY SERVICES LLC
Authorized official
MS. AMA J BAFFOE RN (EXECUTIVE DIRECTOR)
(973) 210-6066
Entity
Organization

Contact information

Practice address
200 MAIN ST, GLEN GARDNER, NJ 08826-3616
(973) 436-4704
(973) 436-4714
Mailing address
209 PASSAIC AVE FL 1, BELLEVILLE, NJ 07109-1960
(973) 436-4704
(973) 436-4714

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
251X00000X
Supports Brokerage Agency
261QA0600X
Adult Day Care Clinic/Center
261QD1600X
Developmental Disabilities Clinic/Center
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
11/15/2025
Last updated
11/15/2025
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