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General NPI Number Information
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NPI Number | 1154796324
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Entity Type | Organization
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Legal Business Name | THE SPECIAL CHILDREN CENTER
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 1400 PROSPECT ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4611
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Country | US
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Telephone | 732-367-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 PROSPECT ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHAYA R BENDER
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Credential |
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Telephone | 732-367-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number | FS4010
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number | FS4010
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number | FS4010
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | FS4010
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License Number State | NJ
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