Provider Demographics
NPI:1629636741
Name:ASSOCIATION FOR THE MULTIPE IMPAIRED BLIND, INC.
Entity type:Organization
Organization Name:ASSOCIATION FOR THE MULTIPE IMPAIRED BLIND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TINIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-262-0082
Mailing Address - Street 1:35 BEAVERSON BLVD BLDG 13
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-262-0082
Mailing Address - Fax:
Practice Address - Street 1:874 GREGORY DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6208
Practice Address - Country:US
Practice Address - Phone:732-262-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities