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General NPI Number Information
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NPI Number | 1457969628
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Entity Type | Organization
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Legal Business Name | FORWARD INTERVENTIONS AND LEARNING, LLC
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 475 JANSEN AVE
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City | AVENEL
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State | NJ
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Zip | 07001-1333
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Country | US
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Telephone | 201-952-9459
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 684
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-0684
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Country | US
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Telephone | 201-952-9459
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ALAIN MOLLINEDO
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Credential | LCSW
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Telephone | 201-952-9459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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