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General NPI Number Information
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NPI Number | 1437086436
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Entity Type | Organization
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Legal Business Name | JONATHAN'S HAVEN LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 167-169 DICKERSON ST
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City | NEWARK
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State | NJ
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Zip | 07107-3222
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Country | US
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Telephone | 973-873-8887
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Fax | 973-228-7068
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Provider Business Mailing Address
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Address Line | PO BOX 354
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City | WEST ORANGE
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State | NJ
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Zip | 07052-0354
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Country | US
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Telephone | 973-873-8887
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Fax | 973-228-7068
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | GWENDOLYN MONANGAI
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Credential |
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Telephone | 973-652-4541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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