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General NPI Number Information
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NPI Number | 1386085652
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE SUPPORT PROGRAM OF NEW JERSEY, INC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 11 SPRING STREET
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-780-1175
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Fax | 732-780-8977
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Provider Business Mailing Address
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Address Line | 11 SPRING STREET
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City | FREEHOLD
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State | NJ
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Zip | 07728-1843
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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 | CHIEF EXECUTIVE OFFICER
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Name | STEVEN M BLACKBURN
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Credential |
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Telephone | 732-414-0081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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