Provider Demographics
NPI:1447957394
Name:A PLACE FOR THE FAMILY LLC
Entity type:Organization
Organization Name:A PLACE FOR THE FAMILY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADU-ANTOH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:929-333-6531
Mailing Address - Street 1:1108 STUYVESANT AVE APT A
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-5112
Mailing Address - Country:US
Mailing Address - Phone:929-333-6531
Mailing Address - Fax:
Practice Address - Street 1:1108 STUYVESANT AVE APT A
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-5112
Practice Address - Country:US
Practice Address - Phone:929-333-6531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty