Provider Demographics
NPI:1336277722
Name:UNION INDUSTRIAL HOME FOR CHILDREN
Entity Type:Organization
Organization Name:UNION INDUSTRIAL HOME FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-695-1492
Mailing Address - Street 1:864 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4408
Mailing Address - Country:US
Mailing Address - Phone:609-695-1492
Mailing Address - Fax:609-695-6323
Practice Address - Street 1:864 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4408
Practice Address - Country:US
Practice Address - Phone:609-695-1492
Practice Address - Fax:609-695-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children