MEDICARE: THE, WARREN COUNTY CHAPTER

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	GH579	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538694492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE, WARREN COUNTY CHAPTER

Provider Business Mailing Address
First Line	:	319 W WASHINGTON AVE
Second Line	:
City	:	WASHINGTON
State	:	NJ
Zip	:	07882-2157
Country	:	US
Telephone Number	:	908-689-7525
Fax Number	:	908-689-4898

Provider Business Practice Location Address
First Line	:	17 HAMPTON TER
Second Line	:
City	:	PHILLIPSBURG
State	:	NJ
Zip	:	08865-2015
Country	:	US
Telephone Number	:	908-859-3846
Fax Number	:	908-859-8593

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN DAVID WHITEHEAD
Credential	:
Telephone Number	:	908-689-7525

Provider Enumeration Date	:	04/27/2017
Last Update Date	:	06/22/2026

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Directions to “THE, WARREN COUNTY CHAPTER ” Practice Location

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