Healthcare Provider Details

I. General information

NPI: 1548803869
Provider Name (Legal Business Name): ALFA DEVELOPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5677 BERKSHIRE VALLEY RD
OAK RIDGE NJ
07438-0255
US

IV. Provider business mailing address

39 OAK RIDGE RD
NEWFOUNDLAND NJ
07435-1403
US

V. Phone/Fax

Practice location:
  • Phone: 973-697-1010
  • Fax:
Mailing address:
  • Phone: 973-697-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA MARIE RUNNE
Title or Position: OFFICE MANAGER
Credential:
Phone: 973-697-1010