MEDICARE: VENTNOR EDUCATIONAL COMMUNITY COMPLEX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)	251300000X	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023264462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTNOR EDUCATIONAL COMMUNITY COMPLEX

Provider Business Mailing Address
First Line	:	400 N LAFAYETTE AVE
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-1026
Country	:	US
Telephone Number	:	609-487-7900
Fax Number	:	609-487-1039

Provider Business Practice Location Address
First Line	:	400 N LAFAYETTE AVE
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-1026
Country	:	US
Telephone Number	:	609-487-7900
Fax Number	:	609-487-1039

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL SERVICES
Name	:	MRS. JOLIE TRABIN
Credential	:	MSW
Telephone Number	:	609-487-7900

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/18/2008

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Directions to “VENTNOR EDUCATIONAL COMMUNITY COMPLEX ” Practice Location

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