Provider Demographics
NPI:1235784158
Name:4TEES COMMUNITY RESOURCES LLC
Entity Type:Organization
Organization Name:4TEES COMMUNITY RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEFEMI
Authorized Official - Suffix:
Authorized Official - Credentials:RNBC,MSN
Authorized Official - Phone:973-444-6512
Mailing Address - Street 1:70 LONG ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1208
Mailing Address - Country:US
Mailing Address - Phone:862-252-9586
Mailing Address - Fax:862-252-9587
Practice Address - Street 1:70 LONG ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1208
Practice Address - Country:US
Practice Address - Phone:862-252-9586
Practice Address - Fax:862-252-9587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health