Provider Demographics
NPI:1831684521
Name:NEW JERSEY CAMP FOR BLIND CHILDREN, INC
Entity type:Organization
Organization Name:NEW JERSEY CAMP FOR BLIND CHILDREN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRYSTYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON GALLANT
Authorized Official - Suffix:
Authorized Official - Credentials:MAT
Authorized Official - Phone:973-627-1114
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-0084
Mailing Address - Country:US
Mailing Address - Phone:973-627-1113
Mailing Address - Fax:
Practice Address - Street 1:27 DURHAM RD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-4601
Practice Address - Country:US
Practice Address - Phone:973-627-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherNON PROFIT TAD ID