Healthcare Provider Details

I. General information

NPI: 1407285026
Provider Name (Legal Business Name): TWIN OAKS COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 WOODLANE RD
MT. HOLLY NJ
08060
US

IV. Provider business mailing address

770 WOODLANE ROAD
MT. HOLLY NJ
08060
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-5928
  • Fax:
Mailing address:
  • Phone: 609-267-5928
  • 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

VIII. Authorized Official

Name: TAYBI GONZALEZ
Title or Position: SUPERVISOR
Credential:
Phone: 856-881-7480