MEDICARE: BANCROFT, A NEW JERSEY NONPROFIT CORPORATION

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

General Provider Information

NPI Number	:	1932740883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANCROFT, A NEW JERSEY NONPROFIT CORPORATION

Provider Business Mailing Address
First Line	:	1255 CALDWELL RD
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-3220
Country	:	US
Telephone Number	:	856-324-3242
Fax Number	:

Provider Business Practice Location Address
First Line	:	4104 HAMILTON DR
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-3121
Country	:	US
Telephone Number	:	800-774-5516
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JENNIFER CRIPPS
Credential	:
Telephone Number	:	856-348-1196

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	11/08/2023

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