Provider Demographics
NPI:1821629775
Name:NJ TRANSITIONAL LIVING FOUNDATION INC
Entity Type:Organization
Organization Name:NJ TRANSITIONAL LIVING FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-318-4453
Mailing Address - Street 1:726 DARTMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-6310
Mailing Address - Country:US
Mailing Address - Phone:856-318-4453
Mailing Address - Fax:
Practice Address - Street 1:726 DARTMOOR AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-6310
Practice Address - Country:US
Practice Address - Phone:856-318-4453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging