Healthcare Provider Details
I. General information
NPI: 1326923608
Provider Name (Legal Business Name): MORNING STAR SUPPORTIVE SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 GORGE RD APT 7H
CLIFFSIDE PARK NJ
07010-2228
US
IV. Provider business mailing address
2509 PARK AVE STE LLD
SOUTH PLAINFIELD NJ
07080-5300
US
V. Phone/Fax
- Phone: 551-312-8522
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HALIMAT
AKANBI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 551-312-8522