Healthcare Provider Details

I. General information

NPI: 1396312138
Provider Name (Legal Business Name): FRIENDS OF CYRUS II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 CARRANZA RD
TABERNACLE NJ
08088-9396
US

IV. Provider business mailing address

PO BOX 108
UPPER SADDLE RIVER NJ
07458-0108
US

V. Phone/Fax

Practice location:
  • Phone: 201-213-1935
  • Fax:
Mailing address:
  • Phone:
  • 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
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NAREN SINGHANI
Title or Position: CHAIRMAN OF BOARD
Credential:
Phone: 201-213-1935