Provider Demographics
NPI:1255922563
Name:LENNON'S HOUSE A NJ NONPROFIT CORP
Entity type:Organization
Organization Name:LENNON'S HOUSE A NJ NONPROFIT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BREWSTER
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-814-2657
Mailing Address - Street 1:17 OAK LN
Mailing Address - Street 2:
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07435-1200
Mailing Address - Country:US
Mailing Address - Phone:973-814-2657
Mailing Address - Fax:
Practice Address - Street 1:21 PINE ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3130
Practice Address - Country:US
Practice Address - Phone:973-453-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities