Provider Demographics
NPI:1427599422
Name:ADOLESCENT & CHILDREN ENRICHMENT SERVICES
Entity Type:Organization
Organization Name:ADOLESCENT & CHILDREN ENRICHMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:732-754-7325
Mailing Address - Street 1:2715 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4539
Mailing Address - Country:US
Mailing Address - Phone:732-754-7325
Mailing Address - Fax:
Practice Address - Street 1:2715 HUDSON ST
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4539
Practice Address - Country:US
Practice Address - Phone:732-754-7325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NJ44SC05227300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management