Provider Demographics
NPI:1831869841
Name:YOUR TRUTH LLC
Entity type:Organization
Organization Name:YOUR TRUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-588-3219
Mailing Address - Street 1:16 GREENE TER
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3906
Mailing Address - Country:US
Mailing Address - Phone:862-588-3219
Mailing Address - Fax:
Practice Address - Street 1:16 GREENE TER
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3906
Practice Address - Country:US
Practice Address - Phone:862-588-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)