Healthcare Provider Details

I. General information

NPI: 1902944853
Provider Name (Legal Business Name): SERV CENTERS OF NEW JERSEY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 W STATE ST
TRENTON NJ
08618-5627
US

IV. Provider business mailing address

20 SCOTCH RD
EWING NJ
08628-2503
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-0212
  • Fax: 609-394-0355
Mailing address:
  • Phone: 609-406-0100
  • Fax: 609-406-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberL41-C1
License Number StateNJ

VIII. Authorized Official

Name: MS. REGINA WIDDOWS
Title or Position: CEO
Credential:
Phone: 609-406-0100