Healthcare Provider Details

I. General information

NPI: 1447750153
Provider Name (Legal Business Name): WECARE ALLIANCE FOR MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 HAMILTON ST APT 2B
RAHWAY NJ
07065-2780
US

IV. Provider business mailing address

768 HAMILTON ST APT 2B
RAHWAY NJ
07065-2780
US

V. Phone/Fax

Practice location:
  • Phone: 917-250-0095
  • Fax:
Mailing address:
  • Phone: 917-250-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. JIMMY N MOMANYI
Title or Position: PRESIDENT
Credential:
Phone: 917-250-0095