Provider Demographics
NPI:1124382502
Name:SOCIAL WORK ON THE GO
Entity Type:Organization
Organization Name:SOCIAL WORK ON THE GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYE-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARCOOPOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-280-5988
Mailing Address - Street 1:PO BOX 2883
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-0383
Mailing Address - Country:US
Mailing Address - Phone:973-280-5988
Mailing Address - Fax:
Practice Address - Street 1:3715 E STATE STREET EXT
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2447
Practice Address - Country:US
Practice Address - Phone:973-280-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400500914251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health