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General NPI Number Information
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NPI Number | 1558061630
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Entity Type | Organization
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Legal Business Name | ADULT INDEPENDENT SERVICES
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1637 FRANKLIN BLVD
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City | LINWOOD
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State | NJ
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Zip | 08221-2219
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Country | US
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Telephone | 954-309-3517
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 TILTON RD # 1093
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234-1831
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Country | US
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Telephone | 954-541-7765
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. DEBRA FREED
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Credential |
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Telephone | 954-541-7765
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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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