Healthcare Provider Details
I. General information
NPI: 1881360618
Provider Name (Legal Business Name): FRIENDS OF CYRUS II INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2021
Last Update Date: 08/20/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 JUNIPER DR
CHERRY HILL NJ
08003-3153
US
IV. Provider business mailing address
15 CORPORATE PL S STE 333
PISCATAWAY NJ
08854-6108
US
V. Phone/Fax
- Phone: 201-213-1935
- Fax:
- Phone: 201-213-1935
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320700000X |
| Taxonomy | Physical Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NAREN
SINGHANI
Title or Position: CHAIRMAN
Credential:
Phone: 201-213-1935