Provider Demographics
NPI:1922262393
Name:THE INSTITUTE FOR FAMILY & ADOLESCENT SVCS INC
Entity Type:Organization
Organization Name:THE INSTITUTE FOR FAMILY & ADOLESCENT SVCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZARERSCU
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LSW
Authorized Official - Phone:908-526-7809
Mailing Address - Street 1:60 FIRST AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869
Mailing Address - Country:US
Mailing Address - Phone:908-526-7809
Mailing Address - Fax:908-526-7809
Practice Address - Street 1:60 FIRST AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869
Practice Address - Country:US
Practice Address - Phone:908-526-7809
Practice Address - Fax:908-526-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04642400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
35404OtherCIGNA BEHAVIORAL HEALTH