Provider Demographics
NPI:1487816492
Name:CORPORATE FAMILY RESOURCES, INC.
Entity Type:Organization
Organization Name:CORPORATE FAMILY RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:ETHEL
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MSW
Authorized Official - Phone:201-670-0269
Mailing Address - Street 1:15 GODWIN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3739
Mailing Address - Country:US
Mailing Address - Phone:201-670-0269
Mailing Address - Fax:201-670-4093
Practice Address - Street 1:15 GODWIN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3739
Practice Address - Country:US
Practice Address - Phone:201-670-0269
Practice Address - Fax:201-670-4093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC012755001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081187Medicare PIN