Provider Demographics
NPI:1770639700
Name:MIDDLESEX COUNTY
Entity Type:Organization
Organization Name:MIDDLESEX COUNTY
Other - Org Name:DEPT OF YOUTH SERVICES MIDDLEFIELDS
Other - Org Type:Other Name
Authorized Official - Title/Position:FREEHOLDER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRABIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-297-8991
Mailing Address - Street 1:PO BOX 7164
Mailing Address - Street 2:99 APPLE ORCHARD RD
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-7164
Mailing Address - Country:US
Mailing Address - Phone:732-297-8991
Mailing Address - Fax:732-297-9462
Practice Address - Street 1:99 APPLE ORCHARD RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-7164
Practice Address - Country:US
Practice Address - Phone:732-297-8991
Practice Address - Fax:732-297-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2360322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8372004Medicaid