Provider Demographics
NPI:1295422822
Name:HENDRICKS HOUSE, INC
Entity type:Organization
Organization Name:HENDRICKS HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PILIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-794-2443
Mailing Address - Street 1:2 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-4621
Mailing Address - Country:US
Mailing Address - Phone:856-794-2443
Mailing Address - Fax:856-794-8887
Practice Address - Street 1:2 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-4621
Practice Address - Country:US
Practice Address - Phone:856-794-2443
Practice Address - Fax:856-794-8887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDRICKS HOUSE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder