Provider Demographics
NPI:1891907408
Name:COUNTY OF ATLANTIC
Entity Type:Organization
Organization Name:COUNTY OF ATLANTIC
Other - Org Name:ATLANTIC COUNTY DEPARTMENT OF HUMAN SERVICES INTERGENERATIONAL SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-345-6700
Mailing Address - Street 1:101 S SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225
Mailing Address - Country:US
Mailing Address - Phone:609-645-7700
Mailing Address - Fax:609-645-5907
Practice Address - Street 1:101 S SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225
Practice Address - Country:US
Practice Address - Phone:609-645-7700
Practice Address - Fax:609-645-5907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8045704Medicaid