Healthcare Provider Details

I. General information

NPI: 1366301665
Provider Name (Legal Business Name): CONNECT PATH SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MORRIS AVE
UNION NJ
07083-7173
US

IV. Provider business mailing address

2003 MORRIS AVE STE 1A
UNION NJ
07083-6081
US

V. Phone/Fax

Practice location:
  • Phone: 908-219-7998
  • Fax:
Mailing address:
  • Phone: 862-224-0892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TAGOUIA T DAVIS
Title or Position: OWNER
Credential:
Phone: 908-219-7998