Laura Fonville

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

LAURA FONVILLE

Practice address

218 Pine Ave
Egg Harbor Township, NJ 08234-5339

Phone

(609) 594-7726

NPI assigned

Apr 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laura Angela Fonville

Title

Director

Phone

(609) 594-7726

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1134626591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 PINE AVE",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345339",
            "telephone_number": "609-594-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 PINE AVE",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345339",
            "telephone_number": "609-594-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA FONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "FONVILLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "609-594-7726"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500321",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Child Intellectual and/or Developmental Disabilities Respite Care in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.