Provider Demographics
NPI:1467895003
Name:TREEHOUSE COMMUNITY SUPPORTS,LLC
Entity Type:Organization
Organization Name:TREEHOUSE COMMUNITY SUPPORTS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:V
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-446-0352
Mailing Address - Street 1:20 CONEY AVE
Mailing Address - Street 2:B
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4516
Mailing Address - Country:US
Mailing Address - Phone:856-696-1780
Mailing Address - Fax:
Practice Address - Street 1:20 CONEY AVE
Practice Address - Street 2:B
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4516
Practice Address - Country:US
Practice Address - Phone:856-696-1780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-13
Last Update Date:2013-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400468905251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services