Provider Demographics
NPI:1467835975
Name:CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC
Entity Type:Organization
Organization Name:CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-629-7939
Mailing Address - Street 1:333 7TH AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5004
Mailing Address - Country:US
Mailing Address - Phone:212-629-7939
Mailing Address - Fax:
Practice Address - Street 1:1 HARVARD WAY STE 3
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4294
Practice Address - Country:US
Practice Address - Phone:908-541-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services