Provider Demographics
NPI:1205361870
Name:JEWISH ASSOCIATION FOR DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:JEWISH ASSOCIATION FOR DEVELOPMENTAL DISABILITIES
Other - Org Name:J-ADD INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-457-0058
Mailing Address - Street 1:190 MOORE ST
Mailing Address - Street 2:SUITE 272
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7424
Mailing Address - Country:US
Mailing Address - Phone:201-457-0058
Mailing Address - Fax:201-457-0025
Practice Address - Street 1:1476 W TERRACE CIR
Practice Address - Street 2:APT 2
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5230
Practice Address - Country:US
Practice Address - Phone:201-837-1401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJGH 1812320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities