Provider Demographics
NPI:1285016816
Name:THE ARC OF BURLINGTON COUNTY, INC.
Entity Type:Organization
Organization Name:THE ARC OF BURLINGTON COUNTY, INC.
Other - Org Name:THE ARC OF BURLINGTON COUNTY - EAYRESTOWN GH
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVADOMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-531-0211
Mailing Address - Street 1:721 EAYRESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-3176
Mailing Address - Country:US
Mailing Address - Phone:609-267-4150
Mailing Address - Fax:
Practice Address - Street 1:721 EAYRESTOWN RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-3176
Practice Address - Country:US
Practice Address - Phone:609-267-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJGH186251C00000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services