Provider Demographics
NPI:1851962393
Name:THE OVERCOMERS FOUNDATION
Entity Type:Organization
Organization Name:THE OVERCOMERS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-342-7584
Mailing Address - Street 1:2106 KAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-342-7584
Mailing Address - Fax:
Practice Address - Street 1:2106 KAY AVENUE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-342-7584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OVERCOMERS ABA SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty