Healthcare Provider Details

I. General information

NPI: 1447701834
Provider Name (Legal Business Name): FUTURE PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 UNION AVE
PATERSON NJ
07502-1852
US

IV. Provider business mailing address

672 US HIGHWAY 202/206
BRIDGEWATER NJ
08807-1747
US

V. Phone/Fax

Practice location:
  • Phone: 973-768-6098
  • Fax:
Mailing address:
  • Phone: 973-768-6098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRE L GREER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW
Phone: 973-768-6098