Provider Demographics
NPI:1174829311
Name:MOTYLEK LLC
Entity Type:Organization
Organization Name:MOTYLEK LLC
Other - Org Name:FAMILY TRANSITION SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOJTCZUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-208-5364
Mailing Address - Street 1:2 MARLTON LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-9799
Mailing Address - Country:US
Mailing Address - Phone:609-324-7601
Mailing Address - Fax:609-324-7601
Practice Address - Street 1:169 WILFRED AVE
Practice Address - Street 2:WILSON COMMUNITY CENTER
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-4955
Practice Address - Country:US
Practice Address - Phone:609-394-0299
Practice Address - Fax:609-324-7601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOTYLEK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-06
Last Update Date:2011-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0252034Medicaid