Provider Demographics
NPI:1992214605
Name:A BETTER CONCEPT
Entity Type:Organization
Organization Name:A BETTER CONCEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOVONNEA
Authorized Official - Middle Name:CHARMAINE
Authorized Official - Last Name:MCKEVER
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:856-287-4191
Mailing Address - Street 1:20 WILDCAT BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4890
Mailing Address - Country:US
Mailing Address - Phone:856-287-4191
Mailing Address - Fax:856-740-0605
Practice Address - Street 1:20 WILDCAT BRANCH DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-4890
Practice Address - Country:US
Practice Address - Phone:856-287-4191
Practice Address - Fax:856-740-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NJ320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450153322OtherCERTIFICATE OF FORMATION
NJ0575534Medicaid