Healthcare Provider Details

I. General information

NPI: 1801262787
Provider Name (Legal Business Name): ASSOC. FOR RETARDED CITIZENS, INC. GLOUCESTER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 NORTH DELSEA DRIVE SPECIAL NEEDS ATS VI
WESTVILLE NJ
08093
US

IV. Provider business mailing address

1555 GATEWAY BOULEVARD
WEST DEPTFORD NJ
08096
US

V. Phone/Fax

Practice location:
  • Phone: 856-848-3909
  • Fax: 856-848-2954
Mailing address:
  • Phone: 856-848-8648
  • Fax: 856-848-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANA RIVERA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 856-848-8648