Healthcare Provider Details

I. General information

NPI: 1003658402
Provider Name (Legal Business Name): HOME LINK INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 E WOOD ST STE 205
VINELAND NJ
08360-3752
US

IV. Provider business mailing address

629 E WOOD ST STE 205
VINELAND NJ
08360-3752
US

V. Phone/Fax

Practice location:
  • Phone: 856-839-0881
  • Fax: 856-839-4813
Mailing address:
  • Phone: 856-839-0881
  • Fax: 856-839-4813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. USIFO EDWARD ASIKHIA
Title or Position: CLINICAL DIRECTOR
Credential: BCBA-D, QBA, MD
Phone: 856-308-3139