Provider Demographics
NPI:1982817219
Name:THE SPECIAL CHILDREN CENTER
Entity Type:Organization
Organization Name:THE SPECIAL CHILDREN CENTER
Other - Org Name:THE SPECIAL CHILDRENS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:732-367-0099
Mailing Address - Street 1:1400 PROSPECT STREET
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-367-0099
Mailing Address - Fax:732-367-1518
Practice Address - Street 1:1400 PROSPECT STREET
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-367-0099
Practice Address - Fax:732-367-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BCBA#1-10-7095103K00000X
NJ44SC05422400104100000X
NJ45SC05413100104100000X
NJ44SC05429800104100000X
NJ45SC05368900104100000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0090158Medicaid