Provider Demographics
NPI:1962774422
Name:TRUE VINE HEALTH CARE SOLUTIONS LLP
Entity type:Organization
Organization Name:TRUE VINE HEALTH CARE SOLUTIONS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSUNTUYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-821-7618
Mailing Address - Street 1:20 JULIE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4622
Mailing Address - Country:US
Mailing Address - Phone:732-821-7618
Mailing Address - Fax:
Practice Address - Street 1:20 JULIE CT
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4622
Practice Address - Country:US
Practice Address - Phone:732-821-7618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0158800302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0158800Medicaid