Provider Demographics
NPI:1265689079
Name:BERGEN COUNTY BOARD OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:BERGEN COUNTY BOARD OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROBARDIER
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:201-368-4297
Mailing Address - Street 1:218 ROUTE 17 NORTH
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3300
Mailing Address - Country:US
Mailing Address - Phone:201-368-4200
Mailing Address - Fax:
Practice Address - Street 1:218 ROUTE 17 NORTH
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3300
Practice Address - Country:US
Practice Address - Phone:201-368-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0058513Medicaid