Provider Demographics
NPI:1629603360
Name:KASEFA FOUNDATION
Entity Type:Organization
Organization Name:KASEFA FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHENISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-417-8742
Mailing Address - Street 1:51 JFK PKWY FL 1
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2713
Mailing Address - Country:US
Mailing Address - Phone:973-417-8742
Mailing Address - Fax:973-751-7172
Practice Address - Street 1:51 JFK PKWY FL 1
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2713
Practice Address - Country:US
Practice Address - Phone:973-417-8742
Practice Address - Fax:973-751-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty