Individual provider · Type 1 NPI
Dyneise Tucker
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Newark, NJ
Practice location
87 2nd St Apt 2
Newark, NJ 07107-3103
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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About NPI 1427683465
Dyneise Tucker's National Provider Identifier is 1427683465, issued on Mar 10, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Newark, NJ. The record was last updated on Mar 10, 2020.