Basic Information
| Provider Information | |||||||||
| NPI: | 1629018791 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEWISH FAMILY & CHILDREN'S SERVICE OF GREATER MERCER COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 707 ALEXANDER ROAD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099878100 | ||||||||
| FaxNumber: | 6099870574 | ||||||||
| Practice Location | |||||||||
| Address1: | 707 ALEXANDER RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085406331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099878100 | ||||||||
| FaxNumber: | 6099870574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 08/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | MILLEMANN | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6099878100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 44SC00858500 | NJ | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.