Provider Demographics
NPI:1285266536
Name:STONEY MAE EMPOWERMENT HOUSE NJ
Entity type:Organization
Organization Name:STONEY MAE EMPOWERMENT HOUSE NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-796-7157
Mailing Address - Street 1:401 MARKET ST UNIT 3054
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08101-8092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 MARKET ST UNIT 3054
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08101-8092
Practice Address - Country:US
Practice Address - Phone:215-796-7157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health