Provider Demographics
NPI:1932172962
Name:COUNTY OF BURLINGTON
Entity Type:Organization
Organization Name:COUNTY OF BURLINGTON
Other - Org Name:BUTTONWOOD HOSPITAL OF BURLINGTON COUNTY - PSYCHIATRIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CULLINAN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:609-726-7066
Mailing Address - Street 1:PO BOX 6000
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-6000
Mailing Address - Country:US
Mailing Address - Phone:609-726-7066
Mailing Address - Fax:609-726-1753
Practice Address - Street 1:600 PEMBERTON-BROWNS MILLS ROAD
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:NJ
Practice Address - Zip Code:08064
Practice Address - Country:US
Practice Address - Phone:609-726-7066
Practice Address - Fax:609-726-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50311283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH50311OtherNJDHSS LICENSE
NJ6812007Medicaid
NJ6812007Medicaid