1508263245 NPI number — MILLHILL CHILD AND FAMILY DEVELOPMENT

Table of content: AMY JO SPENCER RN (NPI 1417761891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508263245 NPI number — MILLHILL CHILD AND FAMILY DEVELOPMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILLHILL CHILD AND FAMILY DEVELOPMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508263245
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 OAKLAND STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 OAKLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08618-3507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-989-7333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
FAIMAN
Authorized Official First Name:
JORDAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official Telephone Number:
609-989-7333

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0186554 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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