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General NPI Number Information
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NPI Number | 1093567976
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Entity Type | Organization
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Legal Business Name | SANKOFA LOVE LLC
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 17 ACADEMY ST STE 1008
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City | NEWARK
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State | NJ
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Zip | 07102-2927
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Country | US
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Telephone | 973-692-8609
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Fax |
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Provider Business Mailing Address
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Address Line | 368 BROAD ST APT 317
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City | NEWARK
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State | NJ
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Zip | 07104-3870
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | REGINA FITCH
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Credential |
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Telephone | 973-692-8609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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