Healthcare Provider Details

I. General information

NPI: 1184472904
Provider Name (Legal Business Name): HOMELESS SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W HANOVER AVE STE 100
MORRISTOWN NJ
07960-2500
US

IV. Provider business mailing address

3 WING DR STE 245
CEDAR KNOLLS NJ
07927-1018
US

V. Phone/Fax

Practice location:
  • Phone: 973-993-0900
  • Fax:
Mailing address:
  • Phone: 973-993-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHANNON MUTI
Title or Position: DIRECTOR OF PROGRAMS & SERVICES
Credential: MSW
Phone: 973-993-0900