Provider Demographics
NPI:1407054406
Name:COUNTY OF SOMERSET TREASURER
Entity Type:Organization
Organization Name:COUNTY OF SOMERSET TREASURER
Other - Org Name:PSYCHIATRIC EMERGENCY SCREENING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HUMAN SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAUPP
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MPHA
Authorized Official - Phone:908-704-6324
Mailing Address - Street 1:PO BOX 3000
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1262
Mailing Address - Country:US
Mailing Address - Phone:908-231-6403
Mailing Address - Fax:908-218-0466
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2519
Practice Address - Country:US
Practice Address - Phone:908-231-6403
Practice Address - Fax:908-218-0466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOMERSET COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-11
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNONE REQUIRED273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0133132Medicaid