Provider Demographics
NPI:1821479494
Name:PERSONALIZED INDEPENDENT LIVING OPPORUNTITIES & TRAINING SERVICES
Entity Type:Organization
Organization Name:PERSONALIZED INDEPENDENT LIVING OPPORUNTITIES & TRAINING SERVICES
Other - Org Name:THE PILOT SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-673-9197
Mailing Address - Street 1:289 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2619
Mailing Address - Country:US
Mailing Address - Phone:856-809-0600
Mailing Address - Fax:856-809-0500
Practice Address - Street 1:283 JACKSON ROAD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009
Practice Address - Country:US
Practice Address - Phone:856-809-0600
Practice Address - Fax:856-809-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services