Provider Demographics
NPI:1558827147
Name:ALTRUISTIC VISIONS A NJ NONPROFIT CORPORATION
Entity Type:Organization
Organization Name:ALTRUISTIC VISIONS A NJ NONPROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MIRLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESPEINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-213-3374
Mailing Address - Street 1:665 SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1610
Mailing Address - Country:US
Mailing Address - Phone:848-213-3374
Mailing Address - Fax:
Practice Address - Street 1:665 SPRINGDALE AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1610
Practice Address - Country:US
Practice Address - Phone:732-910-8485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child