Provider Demographics
NPI:1700562642
Name:PRINCETON CHILD DEVELOPMENT INSTITUTE
Entity type:Organization
Organization Name:PRINCETON CHILD DEVELOPMENT INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-924-6280
Mailing Address - Street 1:300 COLD SOIL ROAD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-924-6280
Mailing Address - Fax:609-924-4119
Practice Address - Street 1:248 PENNINGTON-ROCKY HILL ROAD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-924-6280
Practice Address - Fax:609-924-4119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities