Provider Demographics
NPI:1851643738
Name:MIDDLESEX COUNTY
Entity Type:Organization
Organization Name:MIDDLESEX COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-745-3200
Mailing Address - Street 1:75 BAYARD ST FL 5
Mailing Address - Street 2:OFFICE ON AGING AND DISABLED SERVICES
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2112
Mailing Address - Country:US
Mailing Address - Phone:732-745-3200
Mailing Address - Fax:732-246-5641
Practice Address - Street 1:75 BAYARD ST FL 5
Practice Address - Street 2:OFFICE ON AGING AND DISABLED SERVICES
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2112
Practice Address - Country:US
Practice Address - Phone:732-745-3200
Practice Address - Fax:732-246-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7716915OtherMOLINA MEDICAID SOLUTIONS