Provider Demographics
NPI:1841735487
Name:7TH & MADISON EXTENSIONS LLC
Entity Type:Organization
Organization Name:7TH & MADISON EXTENSIONS LLC
Other - Org Name:7TH & MADISON EXTENSIONS OF EMPOWERMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEMS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:800-936-3256
Mailing Address - Street 1:219 MAIN ST
Mailing Address - Street 2:SUITE 372
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 GATEWAY CTR
Practice Address - Street 2:SUITE 2600
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-5310
Practice Address - Country:US
Practice Address - Phone:800-936-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency