Healthcare Provider Details

I. General information

NPI: 1730232661
Provider Name (Legal Business Name): DEPARTMENT OF CHILDREN AND FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E STATE ST
TRENTON NJ
08608-1715
US

IV. Provider business mailing address

PO BOX 717
TRENTON NJ
08625-0717
US

V. Phone/Fax

Practice location:
  • Phone: 609-292-9041
  • Fax: 609-984-9615
Mailing address:
  • Phone: 609-292-9041
  • Fax: 609-984-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ALFONSO F NICHOLAS
Title or Position: MANAGER
Credential:
Phone: 609-633-6904