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Advoserv of New Jersey, Inc.

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

NPI 1477933422 · NPPES record last updated Mar 11, 2016

Key facts

NPI
1477933422
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
GH1818 (NJ)
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
42 Woodstown Rd
Mullica Hill, NJ 08062-9636
Phone
(856) 241-3320
Fax
(856) 241-3321
NPI assigned
Jun 4, 2015
Organization subpart
Yes
Parent organization (as reported)
ADVOSERV OF NEW JERSEY, INC.

Authorized official

Name
Darren Blough, M.S.W., BCABA
Title
State Director
Phone
(856) 241-3320

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Advoserv of New Jersey Inc (92 organizations share this tax ID)
Part of
Advoserv of New Jersey Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH1818 NJ Yes

Addresses

Primary practice location

42 Woodstown Rd
Mullica Hill, NJ 08062-9636

Mailing address

2520 Wrangle Hill Rd Ste 200
Bear, DE 19701-3856
Phone (302) 365-8050

Other identifiers

IdentifierTypeStateIssuer
0463591MedicaidNJ

Other providers in Mullica Hill, NJ

All providers in Mullica Hill, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.