Provider Demographics
NPI:1386446128
Name:HAZELEY SUPPORTIVE HOUSING SERVICES LLC
Entity type:Organization
Organization Name:HAZELEY SUPPORTIVE HOUSING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-383-7333
Mailing Address - Street 1:515 MULLICA HILL RD APT D213
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1036
Mailing Address - Country:US
Mailing Address - Phone:856-383-7733
Mailing Address - Fax:
Practice Address - Street 1:515 MULLICA HILL RD APT D213
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1036
Practice Address - Country:US
Practice Address - Phone:856-383-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management