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General NPI Number Information
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NPI Number | 1821832312
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Entity Type | Organization
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Legal Business Name | SPECIAL PARENT ADVOCACY GROUP A NJ NON PROFIT CORPORATION
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 1305 CATBIRD DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-8519
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Country | US
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Telephone | 609-968-1172
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Fax |
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Provider Business Mailing Address
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Address Line | 304 ORIOLE DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-8400
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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 | EXECUTIVE DIRECTOR
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Name | NICOLE ANN WHITFIELD
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Credential |
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Telephone | 609-968-1172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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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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