Provider Demographics
NPI:1184001364
Name:DESTINY EARLY CHILDHOOD CONSULTING & DEVELOPMENTAL SERVICES
Entity Type:Organization
Organization Name:DESTINY EARLY CHILDHOOD CONSULTING & DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD DEVELOPMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CADE
Authorized Official - Suffix:
Authorized Official - Credentials:MA EDUCATION
Authorized Official - Phone:973-595-0900
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-0282
Mailing Address - Country:US
Mailing Address - Phone:973-595-0900
Mailing Address - Fax:973-595-0933
Practice Address - Street 1:193 HALEDON AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1272
Practice Address - Country:US
Practice Address - Phone:973-595-0900
Practice Address - Fax:973-595-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ552955252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency