MEDICARE: THE SPECIAL CHILDREN CENTER

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	251C00000X	Developmentally Disabled Services Day Training Agency		NJ

General Provider Information

NPI Number	:	1457727141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SPECIAL CHILDREN CENTER

Provider Business Mailing Address
First Line	:	1400 PROSPECT ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PROSPECT ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4611
Country	:	US
Telephone Number	:	732-367-0099
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CHAYA R BENDER
Credential	:
Telephone Number	:	732-367-0099

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	08/31/2017

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Directions to “THE SPECIAL CHILDREN CENTER ” Practice Location

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