Provider Demographics
NPI:1952971137
Name:IYAHO SOCIAL SERVICES OF NEW JERSEY INC
Entity Type:Organization
Organization Name:IYAHO SOCIAL SERVICES OF NEW JERSEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:EROMOSELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-280-5930
Mailing Address - Street 1:137 EVERGREEN PL STE 3B
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2007
Mailing Address - Country:US
Mailing Address - Phone:516-280-5930
Mailing Address - Fax:516-280-5930
Practice Address - Street 1:491 MANALAPAN RD STE 7
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1891
Practice Address - Country:US
Practice Address - Phone:516-280-5930
Practice Address - Fax:516-280-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp