Healthcare Provider Details

I. General information

NPI: 1154980258
Provider Name (Legal Business Name): CHILES AND CHILES ASSOCIATES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 KENSINGTON AVE
PLAINFIELD NJ
07060-1913
US

IV. Provider business mailing address

767 KENSINGTON AVE
PLAINFIELD NJ
07060-1913
US

V. Phone/Fax

Practice location:
  • Phone: 973-941-1123
  • Fax:
Mailing address:
  • Phone: 973-941-1123
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: OPHELIA CHILES
Title or Position: CEO
Credential:
Phone: 973-941-1123