Healthcare Provider Details

I. General information

NPI: 1801423314
Provider Name (Legal Business Name): WISE HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 BELVIDERE AVE
WASHINGTON NJ
07882-1417
US

IV. Provider business mailing address

126 BELVIDERE AVE
WASHINGTON NJ
07882-1417
US

V. Phone/Fax

Practice location:
  • Phone: 908-235-3885
  • Fax:
Mailing address:
  • Phone: 908-235-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE WEISS
Title or Position: MANAGING MEMBER
Credential:
Phone: 908-235-3885