Provider Demographics
NPI:1942752050
Name:COUNTY HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:COUNTY HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PIUS
Authorized Official - Middle Name:NDE
Authorized Official - Last Name:FON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-702-6407
Mailing Address - Street 1:110 WINSTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1015
Mailing Address - Country:US
Mailing Address - Phone:202-702-6407
Mailing Address - Fax:
Practice Address - Street 1:110 WINSTON RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1015
Practice Address - Country:US
Practice Address - Phone:202-702-5407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services