The Club of Bergen County

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

THE CLUB OF BERGEN COUNTY

Practice address

22-08 Route 208 Ste 8
Fair Lawn, NJ 07410-2609

Phone

(201) 773-9090

NPI assigned

Jun 8, 2023

Organization subpart

No

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

Authorized official

Name

David Gendy, RN

Title

Manager

Phone

(201) 234-9105

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1710671979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22-08 ROUTE 208 STE 8",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-08 ROUTE 208 STE 8",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102609",
            "telephone_number": "201-773-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLUB OF BERGEN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-08",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "GENDY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-234-9105",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Developmentally Disabled Services Day Training Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.