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General NPI Number Information
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NPI Number | 1386022747
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Entity Type | Organization
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Legal Business Name | SEVEN HILLS NEW JERSEY, INC.
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 820 BEAR TAVERN RD
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City | EWING
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State | NJ
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Zip | 08628-1021
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Country | US
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Telephone | 508-755-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 81 HOPE AVE
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City | WORCESTER
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State | MA
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Zip | 01603-2212
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Country | US
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Telephone | 508-755-2340
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. DAVID A. JORDAN
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Credential | DHA, MPA
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Telephone | 508-755-2340
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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 |
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