Provider Demographics
NPI:1245671981
Name:PERSONALIZED INDEPENDENT LIVING OPPORTUNITIES AND TRAINING SERVICES
Entity type:Organization
Organization Name:PERSONALIZED INDEPENDENT LIVING OPPORTUNITIES AND TRAINING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-809-0600
Mailing Address - Street 1:289 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2619
Mailing Address - Country:US
Mailing Address - Phone:856-809-0600
Mailing Address - Fax:856-809-0500
Practice Address - Street 1:289 JACKSON RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2619
Practice Address - Country:US
Practice Address - Phone:856-809-0600
Practice Address - Fax:856-809-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty