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General NPI Number Information
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NPI Number | 1528445772
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Entity Type | Organization
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Legal Business Name | SENIOR SUPPORT NETWORK LLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 100 MERIDIAN PL
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City | HOWELL
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State | NJ
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Zip | 07731-4003
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Country | US
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Telephone | 732-757-2302
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Fax |
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Provider Business Mailing Address
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Address Line | 10 DAY STAR RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-6036
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Country | US
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Telephone | 732-757-2302
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Fax |
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Authorized Official
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Title or Position | PRES/CEO
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Name | ALYSSA FRIEDMAN
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Credential | LSW, LMSW
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Telephone | 732-757-2302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 087958-1
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License Number State | NJ
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