=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134529464
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALUEOPTIONS OF NEW JERSEY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2014
-----------------------------------------------------
Last Update Date | 08/22/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 PENN PLZ E # PP-03V
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07105-2258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-626-2212
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 240 CORPORATE BLVD
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23502-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-459-5200
-----------------------------------------------------
Fax | 757-893-8677
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EVP AND CFO
-----------------------------------------------------
Name | MR. DOUGLAS THOMPSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-459-5200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------