Healthcare Provider Details
I. General information
NPI: 1942350020
Provider Name (Legal Business Name): CAPITOL COUNTY CHILDREN'S COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3535 QUAKERBRIDGE RD SUITE 800
HAMILTON NJ
08619-1200
US
IV. Provider business mailing address
3535 QUAKERBRIDGE RD SUITE 800
HAMILTON NJ
08619-1200
US
V. Phone/Fax
- Phone: 609-584-0888
- Fax:
- Phone: 609-584-0888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
STRANG
Title or Position: BUSINESS MANAGER
Credential:
Phone: 609-584-0888