Provider Demographics
NPI:1639615511
Name:TOWNSHIP OF LYNDHURST/PARKS DEPARTMENT
Entity Type:Organization
Organization Name:TOWNSHIP OF LYNDHURST/PARKS DEPARTMENT
Other - Org Name:LYNDHURST ADULT WORKSHOP
Other - Org Type:Other Name
Authorized Official - Title/Position:WORKSHOP DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-372-1135
Mailing Address - Street 1:250 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1902
Mailing Address - Country:US
Mailing Address - Phone:201-804-2482
Mailing Address - Fax:201-939-6153
Practice Address - Street 1:420 FERN AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-2252
Practice Address - Country:US
Practice Address - Phone:201-372-1135
Practice Address - Fax:201-372-0225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF LYNDHURST/PARKS DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services