Provider Demographics
NPI:1588224117
Name:ASSOCIATES IN MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:ASSOCIATES IN MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CSW, CBT, CCT, C
Authorized Official - Phone:973-762-2020
Mailing Address - Street 1:60 NORTH WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079
Mailing Address - Country:US
Mailing Address - Phone:973-762-2020
Mailing Address - Fax:973-762-2021
Practice Address - Street 1:81 NORTHFIELD AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-762-2020
Practice Address - Fax:973-762-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health