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General NPI Number Information
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NPI Number | 1326658915
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Entity Type | Organization
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Legal Business Name | LEVEL UP
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 5 ARDSLEY AVE
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City | EWING
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State | NJ
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Zip | 08638-2805
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Country | US
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Telephone | 609-379-9690
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Fax | 609-571-3672
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Provider Business Mailing Address
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Address Line | 348 ADELINE ST
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City | TRENTON
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State | NJ
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Zip | 08611-2512
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Country | US
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Telephone | 609-379-9690
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Fax |
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Authorized Official
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Title or Position | CAREGIVER
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Name | MRS. DANNETTE SIMMONS
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Credential |
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Telephone | 609-379-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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