Provider Demographics
NPI:1356864573
Name:WINDMILL ALLIANCE INC.
Entity Type:Organization
Organization Name:WINDMILL ALLIANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR, WMA
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TASSONE-DOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-858-4460
Mailing Address - Street 1:141 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2459
Mailing Address - Country:US
Mailing Address - Phone:201-858-4460
Mailing Address - Fax:201-443-2427
Practice Address - Street 1:331 BROADWAY APT 3
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3547
Practice Address - Country:US
Practice Address - Phone:201-858-4460
Practice Address - Fax:201-443-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSA1320320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities