Provider Demographics
NPI:1710368345
Name:DEVELOPMENTAL DISABILITIES ASSOCIATION OF NEW JERSEY INC.
Entity Type:Organization
Organization Name:DEVELOPMENTAL DISABILITIES ASSOCIATION OF NEW JERSEY INC.
Other - Org Name:FRANKLIN GH
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CASALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-636-6710
Mailing Address - Street 1:40 WOODBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:SEWAREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07077-1351
Mailing Address - Country:US
Mailing Address - Phone:732-636-6710
Mailing Address - Fax:732-636-5936
Practice Address - Street 1:7 EVANS CT
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2324
Practice Address - Country:US
Practice Address - Phone:732-636-6710
Practice Address - Fax:732-636-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities