1588224117 NPI number — ASSOCIATES IN MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

Table of content: LAUREN TAYLOR MILLIGAN AP (NPI 1366928459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588224117 NPI number — ASSOCIATES IN MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES
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:
1588224117
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 NORTH WYOMING AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH ORANGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-762-2020
Provider Business Mailing Address Fax Number:
973-762-2021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81 NORTHFIELD AVENUE
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
WEST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-762-2020
Provider Business Practice Location Address Fax Number:
973-762-2021
Provider Enumeration Date:
06/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
MARTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER/PRESIDENT/CEO
Authorized Official Telephone Number:
973-762-2020

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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