1023232246 NPI number — HOUSING AUTHORITY OF THE CITY OF MILLVILLE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023232246 NPI number — HOUSING AUTHORITY OF THE CITY OF MILLVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSING AUTHORITY OF THE CITY OF MILLVILLE
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:
6
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:
1023232246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 RIVERSIDE DR.
Provider Second Line Business Mailing Address:
BOX 1-G
Provider Business Mailing Address City Name:
MILLVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-825-8869
Provider Business Mailing Address Fax Number:
856-293-1294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 RIVERSIDE DR
Provider Second Line Business Practice Location Address:
BOX 1-G
Provider Business Practice Location Address City Name:
MILLVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-825-8869
Provider Business Practice Location Address Fax Number:
856-825-8669
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHARD
Authorized Official First Name:
BOBBI
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
856-825-8869

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  25A200 , 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: 0000931 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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