Provider Demographics
NPI:1497420871
Name:FECUND MENTORSHIP INC
Entity Type:Organization
Organization Name:FECUND MENTORSHIP INC
Other - Org Name:PROLIFIC MENTORSHIP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-644-8155
Mailing Address - Street 1:539 W COMMODORE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5406
Mailing Address - Country:US
Mailing Address - Phone:732-644-8155
Mailing Address - Fax:
Practice Address - Street 1:539 W COMMODORE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5406
Practice Address - Country:US
Practice Address - Phone:732-644-8155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health