Provider Demographics
NPI:1942350020
Name:CAPITOL COUNTY CHILDREN'S COLLABORATIVE
Entity Type:Organization
Organization Name:CAPITOL COUNTY CHILDREN'S COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-584-0888
Mailing Address - Street 1:3535 QUAKERBRIDGE RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1200
Mailing Address - Country:US
Mailing Address - Phone:609-584-0888
Mailing Address - Fax:
Practice Address - Street 1:3535 QUAKERBRIDGE RD
Practice Address - Street 2:SUITE 800
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1200
Practice Address - Country:US
Practice Address - Phone:609-584-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8457808Medicaid