NPIMap

Organization Active NPI

Four Corners Community Services

  • Developmentally Disabled Services Day Training Agency
  • Oxford, NJ
National Provider Identifier
1124690623
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
FOUR CORNERS COMMUNITY SERVICES
Doing business as
Excel Day Habilitation
Practice address
35B Wall St
Oxford, NJ 07863-6618
Phone
(973) 436-4704
Fax
(973) 436-4704
NPI assigned
Jul 14, 2021
Organization subpart
Yes
Parent organization
FOUR CORNERS COMMUNITY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Ama J Baffoe
Title
Executive Director
Phone
(973) 392-0430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

35B Wall St
Oxford, NJ 07863-6618

Mailing address

209 Passaic Ave
Belleville, NJ 07109-1960
Phone (973) 436-4704

Other names 1

  • Excel Day Habilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fccsnj@outlook.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Four Corners Community Services6 organizations share this tax ID, including this one
Part of
Four Corners Community Services

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

35B Wall St
Oxford, NJ 07863
Phone (973) 436-4704

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1124690623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PASSAIC AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091960",
            "telephone_number": "973-436-4704",
            "fax_number": "973-436-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35B WALL ST",
            "city": "OXFORD",
            "state": "NJ",
            "postal_code": "078636618",
            "telephone_number": "973-436-4704",
            "fax_number": "973-436-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS COMMUNITY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUR CORNERS COMMUNITY SERVICES",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "BAFFOE",
        "authorized_official_first_name": "AMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-392-0430"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fccsnj@outlook.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "35B Wall St",
            "city": "Oxford",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "078636618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Excel Day Habilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.