Provider Demographics
NPI:1669829586
Name:MERAKEY NEW JERSEY
Entity Type:Organization
Organization Name:MERAKEY NEW JERSEY
Other - Org Name:NHS NEW JERSEY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CORP SR. DIRECTOR OF BUSINESS OPS
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:215-836-3131
Mailing Address - Street 1:620 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1810
Mailing Address - Country:US
Mailing Address - Phone:215-836-3131
Mailing Address - Fax:215-273-5975
Practice Address - Street 1:105 EVESBORO MEDFORD RD STE H
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3865
Practice Address - Country:US
Practice Address - Phone:856-797-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services