Provider Demographics
NPI:1356173215
Name:SPECIAL CARE GROUP LLC
Entity type:Organization
Organization Name:SPECIAL CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-218-6089
Mailing Address - Street 1:537 ROSEWOOD TER FL 2
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5832
Mailing Address - Country:US
Mailing Address - Phone:862-218-6089
Mailing Address - Fax:
Practice Address - Street 1:537 ROSEWOOD TER 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5832
Practice Address - Country:US
Practice Address - Phone:862-218-6089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health