Provider Demographics
NPI:1922421593
Name:SPECIAL PARENT ADVOCACY GROUP A NJ NON PROFIT CORPORATION
Entity Type:Organization
Organization Name:SPECIAL PARENT ADVOCACY GROUP A NJ NON PROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-968-1172
Mailing Address - Street 1:1 US HIGHWAY 46 W
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-0220
Mailing Address - Country:US
Mailing Address - Phone:201-509-8961
Mailing Address - Fax:609-642-2398
Practice Address - Street 1:1020 OLD TRENTON RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1206
Practice Address - Country:US
Practice Address - Phone:201-509-8961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-01
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJFR111662385H00000X, 385HR2060X, 385HR2065X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJFR111662OtherNJ FAMILY CARE CHILDCARE PROVIDER