Provider Demographics
NPI:1497992762
Name:TEAM MANAGEMENT 2000 INC, CBO
Entity Type:Organization
Organization Name:TEAM MANAGEMENT 2000 INC, CBO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AVA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-324-2220
Mailing Address - Street 1:84 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7143
Mailing Address - Country:US
Mailing Address - Phone:201-487-4700
Mailing Address - Fax:201-487-4787
Practice Address - Street 1:744 BROAD ST FL 24
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3802
Practice Address - Country:US
Practice Address - Phone:973-973-0425
Practice Address - Fax:973-239-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000054-08251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0183393Medicaid