Healthcare Provider Details

I. General information

NPI: 1023232246
Provider Name (Legal Business Name): HOUSING AUTHORITY OF THE CITY OF MILLVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIVERSIDE DR BOX 1-G
MILLVILLE NJ
08332
US

IV. Provider business mailing address

100 RIVERSIDE DR. BOX 1-G
MILLVILLE NJ
08332
US

V. Phone/Fax

Practice location:
  • Phone: 856-825-8869
  • Fax: 856-825-8669
Mailing address:
  • Phone: 856-825-8869
  • Fax: 856-293-1294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number25A200
License Number StateNJ

VIII. Authorized Official

Name: BOBBI J. CHARD
Title or Position: ADMINISTRATOR
Credential: NJCALA
Phone: 856-825-8869