Provider Demographics
NPI:1841789864
Name:OCCUPATIONAL TRAINING CENTER OF BURLINGTON COUNTY INC.
Entity Type:Organization
Organization Name:OCCUPATIONAL TRAINING CENTER OF BURLINGTON COUNTY INC.
Other - Org Name:KATHLEEN WRIGHT HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAINES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:609-267-6677
Mailing Address - Street 1:2 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4120
Mailing Address - Country:US
Mailing Address - Phone:609-267-6677
Mailing Address - Fax:609-265-8418
Practice Address - Street 1:1 LONGHURST RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1933
Practice Address - Country:US
Practice Address - Phone:856-596-4040
Practice Address - Fax:856-334-8473
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCCUPATIONAL TRAINING CENTER OF BURLINGTON COUNTY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHGH2274320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities