Healthcare Provider Details

I. General information

NPI: 1801753181
Provider Name (Legal Business Name): MAHANAIM SANCTUARY A NJ NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 PERRYVILLE RD
HAMPTON NJ
08827-4222
US

IV. Provider business mailing address

135 PERRYVILLE RD
HAMPTON NJ
08827-4222
US

V. Phone/Fax

Practice location:
  • Phone: 908-230-3618
  • Fax: 908-460-1652
Mailing address:
  • Phone: 908-230-3618
  • Fax: 908-460-1652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE MARCELLE SAINT-PREUX
Title or Position: COO
Credential: NURSE
Phone: 908-230-3618