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Organization

UNLOCKED POTENTIAL, LLC

Active
Other names
Unlocked Potential
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KIMBERLY KEYES LCSW (OWNER/EXECUTIVE DIRECTOR)
(732) 339-3100
Entity
Organization

Contact information

Practice address
331 DORN AVE, MIDDLESEX, NJ 08846-1117
(732) 339-3100
(732) 601-8715
Mailing address
331 DORN AVE, MIDDLESEX, NJ 08846-1117
(732) 339-3100
(732) 601-8715

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508269911
NJ
Enumeration date
01/31/2017
Last updated
01/31/2017
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