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General NPI Number Information
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NPI Number | 1982642641
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Entity Type | Organization
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Legal Business Name | STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 1175 DEHIRSCH AVE
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City | WOODBINE
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State | NJ
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Zip | 08270-2401
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Country | US
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Telephone | 609-861-2164
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Fax | 609-861-5176
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Provider Business Mailing Address
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Address Line | 1175 DEHIRSCH AVE
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City | WOODBINE
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State | NJ
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Zip | 08270-2401
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Country | US
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Telephone | 609-861-2164
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Fax | 609-861-5176
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT J ARMSTRONG
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Credential | RN, BSN, MSA
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Telephone | 609-861-6041
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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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