Healthcare Provider Details

I. General information

NPI: 1801918123
Provider Name (Legal Business Name): PROJECT 99, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SHORT HILLS AVE SUITE 202
SPRINGFIELD NJ
07081-1040
US

IV. Provider business mailing address

212 SHORT HILLS AVE STE 202
SPRINGFIELD NJ
07081-1040
US

V. Phone/Fax

Practice location:
  • Phone: 973-565-9199
  • Fax: 973-565-9599
Mailing address:
  • Phone: 973-565-9199
  • Fax: 973-565-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY M SIMMONS
Title or Position: PRESIDENT
Credential:
Phone: 973-565-9199