Provider Demographics
NPI:1518314178
Name:LATINO FAMILY CONNECTIONS, LLC
Entity Type:Organization
Organization Name:LATINO FAMILY CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-412-3694
Mailing Address - Street 1:2716 GOLDENROD CT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2416
Mailing Address - Country:US
Mailing Address - Phone:609-412-3694
Mailing Address - Fax:
Practice Address - Street 1:911 BERGEN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4317
Practice Address - Country:US
Practice Address - Phone:609-412-3694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ371C00111900251300000X
NJ44SC05372100251S00000X
NJPC002461251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)
No251V00000XAgenciesVoluntary or Charitable