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General NPI Number Information
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NPI Number | 1417756016
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Entity Type | Organization
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Legal Business Name | MAHANAIM SANCTUARY A NJ NONPROFIT CORPORATION
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 37 THIRD ST
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City | STEWARTSVILLE
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State | NJ
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Zip | 08886-3133
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Country | US
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Telephone | 908-460-3038
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Fax | 908-460-1652
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Provider Business Mailing Address
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Address Line | 135 PERRYVILLE RD
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City | HAMPTON
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State | NJ
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Zip | 08827-4222
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Country | US
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Telephone | 908-460-3038
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Fax | 908-460-1652
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Authorized Official
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Title or Position | SECRETARY / PROJECT MANAGER
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Name | DOMINIQUE MARCELLE SAINT-PREUX
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Credential |
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Telephone | 908-230-3618
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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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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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