Healthcare Provider Details

I. General information

NPI: 1326516436
Provider Name (Legal Business Name): ONWARD SUPPORT CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 THERESA ST
EWING NJ
08618-1531
US

IV. Provider business mailing address

72 THERESA ST
EWING NJ
08618-1531
US

V. Phone/Fax

Practice location:
  • Phone: 609-632-3289
  • Fax:
Mailing address:
  • Phone: 609-632-3289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ALICIA DAVIS
Title or Position: CO-OWNER
Credential:
Phone: 609-632-3289