DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM (NPI# 1174976963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174976963 |
| Entity Type | Organization |
| Organization Name | DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM |
| Practice Address |
1000 Rev Dr Martin Luther King Jr Dr Willingboro NJ 08046 |
| Mailing Address |
1543 State Route 27 Suite 24 Somerset NJ 08873-4015 |
| Practice Telephone | 6098712752 |
| Mailing Telephone | 7324637227 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2018-07-13 |
| Authorized Official Name | MR. TIMOTHY MADDEN (CHAIRMAN OF THE BOARD & CEO) |
| Authorized Official Telephone | 6517895905 |
| Is Organization Subpart | Y |
| Parent Organization Name | DUNGARVIN GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0494275 | 05 |
| Street Address |
1000 REV DR MARTIN LUTHER KING JR DR |
| City | WILLINGBORO |
| State | NJ |
| Zip Code | 08046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548910 | Meghan Chan | Pharmacist | 4296 Us-130, Willingboro, NJ 08046 | 2020-11-02 |
| 1861004251 | Magdalena Alicja Szostak | Pharmacist | Pharmacy Dept 5987, 4296 Route 130, Willingboro Nj, Willingboro, NJ 08046 | 2020-08-18 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1144702804 | Iyanuoluwa Oluwafunmiso Alonge | Specialist/Technologist | 2009 Lewis Drive, Willingboro, NJ 08046 | 2018-08-29 |
| 1972095826 | Felicia Ann Ellis | Behavior Technician | 38 Trinity Turn, Wilingboro, NJ 08046 | 2018-06-05 |
| 1134630510 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 2091 Route 130 N, Willingboro, NJ 08046 | 2017-10-12 |
| 1205387560 | Lj's Senior Care Services LLC | Home Health | 8 Peartree Lane, Willingboro, NJ 08046 | 2016-10-20 |
| 1548633845 | Caringhouse Projects, Inc | Respite Care | 48 Toledo Lane, Willingboro, NJ 08046 | 2015-11-09 |
| 1275927352 | Cheryl Louise Avent-price | Social Worker | 130 Tiffany Lane, Willingboro, NJ 08046 | 2015-03-26 |
| 1457740482 | Laquista Erinna | Social Worker | 200 Campbell Dr Ste 105f, Willingboro, NJ 08046 | 2015-01-14 |
| Find all providers in zip 08046 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294858 | Youth Consultation Service Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 Echohill Ln, Willingboro, NJ 08046-2205 | 2020-10-29 |
| 1225532179 | Youth Consultation Service, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 144 Toledo Ln, Willingboro, NJ 08046-3707 | 2018-03-23 |
| 1356841043 | Rem New Jersey Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2 Pheasant Ln, Willingboro, NJ 08046-2733 | 2018-02-19 |
| 1831607225 | Nj Mentor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 20 Bancroft Ln, Willingboro, NJ 08046-3902 | 2018-01-19 |
| 1639687023 | Nj Mentor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13 Northampton Dr, Willingboro, NJ 08046-1324 | 2018-01-19 |
| 1689189946 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Needwood Ln, Willingboro, NJ 08046-1902 | 2017-12-08 |
| 1144735903 | Noorane Syed | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 52 Maplewick Ln, Willingboro, NJ 08046-2905 | 2017-12-02 |
| 1841702248 | Prince Association for The Developmentally Disabled, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 20 Twisting Ln, Willingboro, NJ 08046-4116 | 2017-10-26 |
| 1013386218 | Community Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 32 Tinker Pl, Willingboro, NJ 08046-3713 | 2015-09-17 |
| 1508242330 | Serv Achievement Centers Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12 Creekview Rd, Willingboro, NJ 08046-3527 | 2015-08-04 |
| Find all providers in WILLINGBORO | ||||
| City | WILLINGBORO |
| Zip Code | 08046 |
Please comment or provide details below to improve the information on DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.