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General NPI Number Information
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NPI Number | 1639615511
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Entity Type | Organization
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Legal Business Name | TOWNSHIP OF LYNDHURST/PARKS DEPARTMENT
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Dates
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Enumeration Date | 01/16/2017
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 420 FERN AVE 1ST FLOOR
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City | LYNDHURST
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State | NJ
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Zip | 07071-2252
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Country | US
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Telephone | 201-372-1135
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Fax | 201-372-0225
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Provider Business Mailing Address
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Address Line | 250 CLEVELAND AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1902
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Country | US
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Telephone | 201-804-2482
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Fax | 201-939-6153
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Authorized Official
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Title or Position | WORKSHOP DIRECTOR
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Name | MISS KELLY ANN KEENAN
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Credential |
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Telephone | 201-372-1135
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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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