NPIMap

Prince Association for the Developmentally Disabled, Inc.

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Edgewater Park, NJ

NPI 1265828396 · NPPES record last updated Nov 15, 2016

Key facts

NPI
1265828396
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
PRINCE ASSOCIATION FOR THE DEVELOPMENTALLY DISABLED, INC.
Practice address
106 N Garden Blvd
Edgewater Park, NJ 08010-2147
Phone
(609) 877-6920
NPI assigned
Apr 15, 2015
Organization subpart
No

Authorized official

Name
Willa Prince
Title
Executive Director
Phone
(609) 877-6745

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Prince Association for the Developmentally Disabled Inc (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

106 N Garden Blvd
Edgewater Park, NJ 08010-2147

Mailing address

20 Twisting LN
Willingboro, NJ 08046-4116

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 15, 2016.

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1265828396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TWISTING LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080464116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N GARDEN BLVD",
            "city": "EDGEWATER PARK",
            "state": "NJ",
            "postal_code": "080102147",
            "telephone_number": "609-877-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE ASSOCIATION FOR THE DEVELOPMENTALLY DISABLED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "WILLA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "609-877-6745"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater Park, NJ

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