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NPI Code Detail

MEDICARE: DEVELOPMENTAL DISABILITIES HEALTH PARTNERS CORP

MEDICARE: DEVELOPMENTAL DISABILITIES HEALTH PARTNERS CORP
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
1103K00000XBehavior AnalystNJ

Other Identifiers

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

General Provider Information

NPI Number : 1992057160
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEVELOPMENTAL DISABILITIES HEALTH PARTNERS CORP
Provider Business Mailing Address
First Line : 1285 BROAD ST
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3045
Country : US
Telephone Number : 973-338-4200
Fax Number : 973-338-4440
Provider Business Practice Location Address
First Line : 1285 BROAD ST
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3045
Country : US
Telephone Number : 973-338-4200
Fax Number : 973-338-4440
Authorized Official
Title or Position : PRESIDENT
Name : KEVIN K WALSH
Credential : PH.D.
Telephone Number : 856-697-7490
Provider Enumeration Date : 10/11/2012
Last Update Date : 09/17/2014

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Directions to “DEVELOPMENTAL DISABILITIES HEALTH PARTNERS CORP ” Practice Location

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