Davon Bennett
Community/Behavioral Health in Newark, NJ. Individual provider (NPI-1).
NPI number1699151977
StatusActive
Last updated in NPPESAug 10, 2015
Details
- NPI
- 1699151977
- Entity type
- Individual (NPI-1)
- Name
- Davon Bennett
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 10, 2015
- Last updated
- Aug 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251B00000X | Case Management | – | NJ | |
| 251X00000X | Supports Brokerage | – | NJ |
Practice location
525 S 10th StNewark, NJ 07103-1828
Phone 862-588-1277
Mailing address
525 S 10th StNewark, NJ 07103-1828
Phone 862-588-1277
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