Healthcare Provider Details

I. General information

NPI: 1578819710
Provider Name (Legal Business Name): CIS AFFORDABLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CROSSWICKS ST
BORDENTOWN NJ
08505-1740
US

IV. Provider business mailing address

1970 BRUNSWICK AVENUE - SUITE 100
LAWRENCEVILLE NJ
08648
US

V. Phone/Fax

Practice location:
  • Phone: 609-298-2229
  • Fax:
Mailing address:
  • Phone: 609-298-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTIANA FOGLIO
Title or Position: MEMBER
Credential:
Phone: 609-298-2229