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General NPI Number Information
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NPI Number | 1750887071
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Entity Type | Organization
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Legal Business Name | ABIDING LOVE INTERNATIONAL FELLOWSHIP
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 210 GENESEE ST
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City | TRENTON
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State | NJ
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Zip | 08611-1910
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Country | US
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Telephone | 609-392-0032
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Fax | 609-530-1348
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Provider Business Mailing Address
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Address Line | 210 GENESEE ST
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City | TRENTON
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State | NJ
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Zip | 08611-1910
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Country | US
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Telephone | 609-392-0032
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Fax | 609-530-1348
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | DR. ADEKEMI OLUBUKOLA BANKOLE
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Credential | ED.D
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Telephone | 609-273-4651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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