Healthcare Provider Details

I. General information

NPI: 1770639700
Provider Name (Legal Business Name): MIDDLESEX COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 APPLE ORCHARD RD
NORTH BRUNSWICK NJ
08902-7164
US

IV. Provider business mailing address

PO BOX 7164 99 APPLE ORCHARD RD
NORTH BRUNSWICK NJ
08902-7164
US

V. Phone/Fax

Practice location:
  • Phone: 732-297-8991
  • Fax: 732-297-9462
Mailing address:
  • Phone: 732-297-8991
  • Fax: 732-297-9462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number2360
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID CRABIEL
Title or Position: FREEHOLDER DIRECTOR
Credential:
Phone: 732-297-8991