Provider Demographics
NPI:1528593829
Name:JEWISH ASSOCIATION FOR DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:JEWISH ASSOCIATION FOR DEVELOPMENTAL DISABILITIES
Other - Org Name:J-ADD INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-457-0058
Mailing Address - Street 1:190 MOORE ST
Mailing Address - Street 2:SUITE 272
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7424
Mailing Address - Country:US
Mailing Address - Phone:201-457-0058
Mailing Address - Fax:201-457-0025
Practice Address - Street 1:122 NEW BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4115
Practice Address - Country:US
Practice Address - Phone:201-439-1433
Practice Address - Fax:201-439-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSA580320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities