Healthcare Provider Details

I. General information

NPI: 1023425535
Provider Name (Legal Business Name): JERSEY CAPE DIAGNOSTIC, TRAINING AND OPPORTUNITY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MOORE RD DN 606
CAPE MAY COURT HOUSE NJ
08210-1654
US

IV. Provider business mailing address

4 MOORE RD DN 606
CAPE MAY COURT HOUSE NJ
08210-1654
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-4117
  • Fax: 609-465-3899
Mailing address:
  • Phone: 609-465-4117
  • Fax: 609-465-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH R SITTINERI
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR
Credential:
Phone: 609-465-4117