Provider Demographics
NPI:1598977399
Name:MONMOUTH COUNTY DIVISION OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:MONMOUTH COUNTY DIVISION OF SOCIAL SERVICES
Other - Org Name:MCDSS
Other - Org Type:Other Name
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KULKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-431-7391
Mailing Address - Street 1:ONE MAIN ST.
Mailing Address - Street 2:HALL OF RECORDS, FINANCE DEPT. 3RD FLOOR
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-431-7391
Mailing Address - Fax:
Practice Address - Street 1:2405 ROUTE 66
Practice Address - Street 2:
Practice Address - City:OCEAN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:732-502-5870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8925305Medicaid