=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528909959
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PYRAMID HOUSE FOUNDATION, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2026
-----------------------------------------------------
Last Update Date | 04/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 REYNOLDS ST
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07050-3218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-845-8956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 391 TREMONT PL
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07050-2020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-845-8956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | JENELLE HUDSON
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 908-845-8956
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171W00000X
-----------------------------------------------------
Taxonomy Name | Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------