Provider Demographics
NPI:1225253701
Name:CUMBERLAND COUNTY OFFICE ON AGING
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY OFFICE ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISONO
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1856-453-2222
Mailing Address - Street 1:790 E COMMERCE ST
Mailing Address - Street 2:590 SHILOH PIKE, HOPEWELL TWP BLDG
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-2269
Mailing Address - Country:US
Mailing Address - Phone:856-453-8066
Mailing Address - Fax:
Practice Address - Street 1:590 SHILOH PIKE
Practice Address - Street 2:HOPEWELL TWP BLDG
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302
Practice Address - Country:US
Practice Address - Phone:856-453-8066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8092206Medicaid