Advoserv of New Jersey, Inc.

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

NPI 1972089753 · NPPES record last updated Jul 16, 2018

Key facts

NPI
1972089753
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
ADVOSERV OF NEW JERSEY, INC.
Practice address
1144 River Rd
Ewing, NJ 08628-2106
Phone
(856) 241-3320
Fax
(856) 241-3321
NPI assigned
Jul 16, 2018
Organization subpart
Yes
Parent organization (as reported)
ADVOSERV OF NEW JERSEY, INC.

Authorized official

Name
Michael Wilder, MHSA
Title
Senior VP of Operations
Phone
(856) 241-3320

Corporate family (same tax ID) 14

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 Yes

Addresses

Primary practice location

1144 River Rd
Ewing, NJ 08628-2106

Mailing address

510 Heron Dr Ste 114
Swedesboro, NJ 08085-1767
Phone (856) 241-3320

Other identifiers

IdentifierTypeStateIssuer
0463591MedicaidNJ

Other providers in Ewing, NJ

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

Sources for this page

Verify at the official NPI Registry.