Healthcare Provider Details

I. General information

NPI: 1972900777
Provider Name (Legal Business Name): ADVOCACY FAMILY SUPPORT SERVICES.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 LA GORCE BLVD
BURLINGTON NJ
08016-2938
US

IV. Provider business mailing address

41 LA GORCE BLVD
BURLINGTON TWP NJ
08016
US

V. Phone/Fax

Practice location:
  • Phone: 732-762-8739
  • Fax:
Mailing address:
  • Phone: 732-762-8739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number103TM1800X
License Number StateNJ

VIII. Authorized Official

Name: MS. IJEOMA NNEDINMA SALAMI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MASTERS DEGREE
Phone: 732-762-8739