Provider Demographics
NPI:1225287113
Name:HENRY J AUSTIN HEALTH CENTER, INC
Entity Type:Organization
Organization Name:HENRY J AUSTIN HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:YULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-278-5950
Mailing Address - Street 1:321 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4741
Mailing Address - Country:US
Mailing Address - Phone:609-278-5900
Mailing Address - Fax:609-695-3532
Practice Address - Street 1:1544 KUSER RD
Practice Address - Street 2:SUITE C 6& 7
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3830
Practice Address - Country:US
Practice Address - Phone:609-585-4606
Practice Address - Fax:609-585-4608
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY J AUSTIN HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24227261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ24227OtherSTATE LIC NUMBER