Laquan R Shamberger
Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child in Maplewood, NJ. Individual provider (NPI-1).
NPI number1497400501
StatusActive
Last updated in NPPESFeb 16, 2022
Details
- NPI
- 1497400501
- Entity type
- Individual (NPI-1)
- Name
- Mr. Laquan R Shamberger
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 16, 2022
- Certification date
- Feb 16, 2022
- Last updated
- Feb 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | NJ | Yes |
| 385HR2065X | Respite Care, Respite Care, Physical Disabilities, Child | – | NJ |
Practice location
109 Woodside RdMaplewood, NJ 07040-1950
Phone 862-703-8237
Mailing address
109 Woodside RdMaplewood, NJ 07040-1950
Phone 862-703-8237
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