1093180861 NPI number — INSTITUTE FOR BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES

Table of content: KIMBERLY ANN OPPLIGER MSW (NPI 1366566218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093180861 NPI number — INSTITUTE FOR BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSTITUTE FOR BEHAVIORAL 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:
1093180861
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1980 SPRINGFIELD AVE
Provider Second Line Business Mailing Address:
SUITE 4L
Provider Business Mailing Address City Name:
MAPLEWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07040-3440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-604-2433
Provider Business Mailing Address Fax Number:
862-930-4862

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1980 SPRINGFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE 4L
Provider Business Practice Location Address City Name:
MAPLEWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07040-3440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-604-2433
Provider Business Practice Location Address Fax Number:
862-930-4862
Provider Enumeration Date:
12/04/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CEASER
Authorized Official First Name:
DAMON
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
888-604-2433

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0490270 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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