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General NPI Number Information
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NPI Number | 1639643299
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Entity Type | Organization
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Legal Business Name | A.W. HOLDINGS, LLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 3322 ROUTE 22 STE 902
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City | BRANCHBURG
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State | NJ
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Zip | 08876-4402
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Country | US
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Telephone | 908-829-3553
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Fax |
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Provider Business Mailing Address
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Address Line | 8515 BLUFFTON RD
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City | FORT WAYNE
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State | IN
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Zip | 46809-3022
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Country | US
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Telephone | 260-744-6145
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | NANCY ANN BOBAY
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Credential |
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Telephone | 260-207-5604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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