Provider Demographics
NPI:1245646066
Name:THE ALCOVE CENTER FOR GRIEVING CHILDREN AND FAMILIES, INC
Entity type:Organization
Organization Name:THE ALCOVE CENTER FOR GRIEVING CHILDREN AND FAMILIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMTOV
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:609-484-1133
Mailing Address - Street 1:376 TILTON RD - REAR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225
Mailing Address - Country:US
Mailing Address - Phone:609-484-1133
Mailing Address - Fax:609-484-3188
Practice Address - Street 1:376 TILTON RD - REAR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225
Practice Address - Country:US
Practice Address - Phone:609-484-1133
Practice Address - Fax:609-484-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007612001041C0700X
NJ44SL057939001041C0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty