Healthcare Provider Details

I. General information

NPI: 1558407528
Provider Name (Legal Business Name): CARING FAMILY COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W COMMODORE BLVD
JACKSON NJ
08527-5372
US

IV. Provider business mailing address

1021 W COMMODORE BLVD
JACKSON NJ
08527-5372
US

V. Phone/Fax

Practice location:
  • Phone: 732-780-2799
  • Fax: 732-780-2899
Mailing address:
  • Phone: 732-780-2799
  • Fax: 732-780-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1272517
License Number StateNJ

VIII. Authorized Official

Name: MR. RANDY PITTMAN
Title or Position: BUSINESS ADMINSTRATOR
Credential: RN,MSN,MBA
Phone: 732-780-2799