Healthcare Provider Details

I. General information

NPI: 1740853498
Provider Name (Legal Business Name): FRIENDS OF CYRUS II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 07/21/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 WOODLAND AVE
CHERRY HILL NJ
08002-4420
US

IV. Provider business mailing address

15 CORPORATE PL S STE 333
PISCATAWAY NJ
08854-6108
US

V. Phone/Fax

Practice location:
  • Phone: 201-213-1935
  • Fax:
Mailing address:
  • Phone: 201-213-1935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NAREN SINGHANI
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 201-213-1935