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General NPI Number Information
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NPI Number | 1871362996
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Entity Type | Organization
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Legal Business Name | K & J MENDING HEARTS
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 235 RALPH ST
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3215
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Country | US
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Telephone | 862-501-8501
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Fax |
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Provider Business Mailing Address
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Address Line | 14 YATES AVE
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City | NEWARK
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State | NJ
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Zip | 07112-1638
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Country | US
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Telephone | 862-215-9063
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Fax |
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Authorized Official
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Title or Position | ASST DIR
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Name | JAMES MORRISON
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Credential |
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Telephone | 862-215-9063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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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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