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General NPI Number Information
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NPI Number | 1720112915
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Entity Type | Organization
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Legal Business Name | PLAID HOUSE INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 54 WESTERN AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 972-267-4008
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Fax | 973-267-7836
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Provider Business Mailing Address
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Address Line | 54 WESTERN AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 972-267-4008
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Fax | 973-267-7836
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NEVILLE NEWTON
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Credential |
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Telephone | 973-267-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 2420
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License Number State | NJ
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