Provider Demographics
NPI:1871046961
Name:MALVERN INSTITUTE OF HUNTERDON CO,LLC
Entity Type:Organization
Organization Name:MALVERN INSTITUTE OF HUNTERDON CO,LLC
Other - Org Name:MALVERN INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:KARDON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-840-1192
Mailing Address - Street 1:200 SANATORIUM RD
Mailing Address - Street 2:
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3342
Mailing Address - Country:US
Mailing Address - Phone:215-840-1192
Mailing Address - Fax:
Practice Address - Street 1:200 SANATORIUM RD
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3342
Practice Address - Country:US
Practice Address - Phone:215-840-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PPROGRESSIONS COMPANIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility