Provider Demographics
NPI:1720028145
Name:JEWISH FAMILY & VOCATIONAL SERVICES OF MIDDLESEX COUNTY INC.
Entity Type:Organization
Organization Name:JEWISH FAMILY & VOCATIONAL SERVICES OF MIDDLESEX COUNTY INC.
Other - Org Name:JEWISH FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-777-1940
Mailing Address - Street 1:219 BLACK HORSE LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4301
Mailing Address - Country:US
Mailing Address - Phone:732-777-1940
Mailing Address - Fax:732-777-1889
Practice Address - Street 1:1600 PERRINEVILLE RD STE 52
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-4903
Practice Address - Country:US
Practice Address - Phone:609-395-7979
Practice Address - Fax:609-395-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100150604OtherOUTPATIENT MH LICENSE
NJ0045608Medicaid
NJ100150404OtherOUTPATIENT MH LICENSE