Provider Demographics
NPI:1851918544
Name:PRAISE FOUNDATION LLC
Entity Type:Organization
Organization Name:PRAISE FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLAPEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OBOLANLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-994-5080
Mailing Address - Street 1:68 GARSIDE ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1006
Mailing Address - Country:US
Mailing Address - Phone:862-930-6688
Mailing Address - Fax:
Practice Address - Street 1:68 GARSIDE ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1006
Practice Address - Country:US
Practice Address - Phone:862-930-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities