Provider Demographics
NPI:1689155582
Name:DARBOUZE, LLC
Entity type:Organization
Organization Name:DARBOUZE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-676-1148
Mailing Address - Street 1:419 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2713
Mailing Address - Country:US
Mailing Address - Phone:215-479-0774
Mailing Address - Fax:856-242-2955
Practice Address - Street 1:419 DAVISVILLE RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2713
Practice Address - Country:US
Practice Address - Phone:215-479-0774
Practice Address - Fax:856-242-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056939001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty