Healthcare Provider Details

I. General information

NPI: 1851144729
Provider Name (Legal Business Name): BROTHERS BUILDING A BETTER NATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 BROAD ST STE 240
NEWARK NJ
07102-4417
US

IV. Provider business mailing address

625 BROAD ST STE 240
NEWARK NJ
07102-4417
US

V. Phone/Fax

Practice location:
  • Phone: 973-434-5081
  • Fax: 833-973-6133
Mailing address:
  • Phone: 973-434-5081
  • Fax: 833-973-6133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. QUADEER LAMAR PORTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 973-991-7849