Provider Demographics
NPI:1912924887
Name:FAMILY & CHILDRENS SRVCS OF CENTRAL NJ
Entity Type:Organization
Organization Name:FAMILY & CHILDRENS SRVCS OF CENTRAL NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:609-924-2098
Mailing Address - Street 1:120 JOHN ST
Mailing Address - Street 2:STE 6
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-924-2098
Mailing Address - Fax:609-924-7826
Practice Address - Street 1:120 JOHN ST
Practice Address - Street 2:STE 6
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-924-7826
Practice Address - Fax:609-924-7826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051721001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
064957BFKMedicare ID - Type Unspecified