Provider Demographics
NPI:1235306903
Name:LITTLE HILL FOUNDATION
Entity Type:Organization
Organization Name:LITTLE HILL FOUNDATION
Other - Org Name:LITTLE HILL ALINA LODGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:YURGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-362-6114
Mailing Address - Street 1:PO BOX G
Mailing Address - Street 2:61 WARD ROAD
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-0966
Mailing Address - Country:US
Mailing Address - Phone:908-362-6114
Mailing Address - Fax:908-362-7569
Practice Address - Street 1:61 WARD RD
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07825-9636
Practice Address - Country:US
Practice Address - Phone:908-362-6114
Practice Address - Fax:908-362-7569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31030324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ314919Medicare UPIN