Provider Demographics
NPI:1801602537
Name:PEACE JOURNEY
Entity type:Organization
Organization Name:PEACE JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAJR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAAM-GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-803-9550
Mailing Address - Street 1:21 PATTON DR APT A
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5283
Mailing Address - Country:US
Mailing Address - Phone:908-803-9550
Mailing Address - Fax:
Practice Address - Street 1:21 PATTON DR APT A
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5283
Practice Address - Country:US
Practice Address - Phone:908-803-9550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health