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DUNGARVIN NEW JERSEY LLC-CRANSTON NPI 1912388471


NPI Information

NPI: 1912388471
Provider Name: DUNGARVIN NEW JERSEY, LLC-CRANSTON
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
30 CRANSTON RD
KENDALL PARK, NJ
ZIP 08824
Phone: (732) 422-2518
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DUNGARVIN NEW JERSEY, LLC-CRANSTON is a community based residential treatment facility, intellectual and/or developmental disabilities in Kendall Park, NJ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. DUNGARVIN NEW JERSEY, LLC-CRANSTON NPI is 1912388471. The provider is registered as an organization entity type.

The provider's business location address is:

30 CRANSTON RD
KENDALL PARK, NJ
ZIP 08824
Phone: (732) 422-2518

The provider's authorized official is Timothy Madden .
The authorized official title is Chairman Of The Board & Ceo and has the following contact phone number (651) 789-5905.

The enumeration date for this NPI number is 6/10/2015 and was last updated on 6/10/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10494275MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.