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General NPI Number Information
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NPI Number | 1174997340
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Entity Type | Organization
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Legal Business Name | CINNAMINSON ATS
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Dates
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Enumeration Date | 11/25/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1204 SHERWIN WILLIAMS PLAZA RT. 130 N SUITE 14 AND 15
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City | CINNAMINSON
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State | NJ
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Zip | 08077-6360
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Country | US
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Telephone | 856-829-5741
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Fax | 856-829-5305
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Provider Business Mailing Address
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Address Line | 1204 SHERWIN WILLIAMS PLAZA RT. 130 N
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City | CINNAMINSON
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State | NJ
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Zip | 08077-6360
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Country | US
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Telephone | 856-829-5741
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Fax | 856-829-5305
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Authorized Official
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Title or Position | ASSISTANT FINANCIAL COORDINATOR
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Name | JOHN MCDONALD
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Credential | MBA
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Telephone | 856-456-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NJ
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