Provider Demographics
NPI:1841075199
Name:WALLYNZAVY'S AUTISTIC KIDS CAN DO
Entity type:Organization
Organization Name:WALLYNZAVY'S AUTISTIC KIDS CAN DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TALEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-753-7333
Mailing Address - Street 1:62 DEKALB AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07063-1020
Mailing Address - Country:US
Mailing Address - Phone:908-753-7333
Mailing Address - Fax:908-757-0581
Practice Address - Street 1:1010 PARK AVE STE 202
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3024
Practice Address - Country:US
Practice Address - Phone:908-753-7333
Practice Address - Fax:908-757-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child