Provider Demographics
NPI:1972112670
Name:TREE HOUSE ENT CULTRAL ARTS MOVEMENT INC
Entity Type:Organization
Organization Name:TREE HOUSE ENT CULTRAL ARTS MOVEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-393-3449
Mailing Address - Street 1:462 SANDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-1602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:462 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-1602
Practice Address - Country:US
Practice Address - Phone:973-393-3449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization