Provider Demographics
NPI:1790021152
Name:SPECIAL CARE COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:SPECIAL CARE COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CABALFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN
Authorized Official - Phone:732-599-9794
Mailing Address - Street 1:17 MAY CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2413
Mailing Address - Country:US
Mailing Address - Phone:732-752-4366
Mailing Address - Fax:
Practice Address - Street 1:17 MAY CT
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2413
Practice Address - Country:US
Practice Address - Phone:732-752-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ311Z00000X311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility