MEDICARE: TRAINING WITH A PURPOSE LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1982052569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAINING WITH A PURPOSE LLC.

Provider Business Mailing Address
First Line	:	65 ROCK RD
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-1568
Country	:	US
Telephone Number	:	973-295-2143
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 ROCK RD
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-1568
Country	:	US
Telephone Number	:	973-295-2143
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. THOMAS LEO DALTON JR.
Credential	:
Telephone Number	:	973-295-2143

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	05/24/2016

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Directions to “TRAINING WITH A PURPOSE LLC. ” Practice Location

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