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General NPI Number Information
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NPI Number | 1093822264
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Entity Type | Organization
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Legal Business Name | DAYTOP VILLAGE OF NJ
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 80 W MAIN ST
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City | MENDHAM
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State | NJ
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Zip | 07945-1230
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Country | US
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Telephone | 973-543-5656
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Fax | 973-543-5273
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Provider Business Mailing Address
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Address Line | PO BOX 310
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City | MENDHAM
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State | NJ
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Zip | 07945-1230
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Country | US
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Telephone | 862-260-9460
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Fax | 862-260-9461
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE & CONTROLLER
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Name | MR. STEPHEN SCRAPE
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Credential |
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Telephone | 862-260-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | AS0002
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License Number State | NJ
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