Provider Demographics
NPI:1760782957
Name:HARMONY PLACE DAS PROGRAM LLC
Entity Type:Organization
Organization Name:HARMONY PLACE DAS PROGRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-4466
Mailing Address - Street 1:776 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3031
Mailing Address - Country:US
Mailing Address - Phone:732-364-4466
Mailing Address - Fax:732-364-7725
Practice Address - Street 1:7070 KAIGHNS AVE # A
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4421
Practice Address - Country:US
Practice Address - Phone:732-364-4466
Practice Address - Fax:732-364-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center