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General NPI Number Information
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NPI Number | 1285442806
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Entity Type | Organization
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Legal Business Name | NEW JERSEY GROWTH PARTNERS
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 476 W WALNUT RD APT 58
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City | VINELAND
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State | NJ
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Zip | 08360-6354
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Country | US
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Telephone | 856-558-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 476 W WALNUT RD APT 58
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City | VINELAND
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State | NJ
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Zip | 08360-6354
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Country | US
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Telephone | 856-558-1669
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BARSHAY L GRAVES
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Credential |
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Telephone | 856-558-1669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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