Provider Demographics
NPI:1538497516
Name:KINGLEY HEALTH SERVICES NJ LLC
Entity Type:Organization
Organization Name:KINGLEY HEALTH SERVICES NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-903-1670
Mailing Address - Street 1:20 THISTLE LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5564
Mailing Address - Country:US
Mailing Address - Phone:908-903-1670
Mailing Address - Fax:908-903-1672
Practice Address - Street 1:530 GREEN ST
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2654
Practice Address - Country:US
Practice Address - Phone:732-283-1900
Practice Address - Fax:908-903-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty