Provider Demographics
NPI:1629018791
Name:JEWISH FAMILY & CHILDREN'S SERVICE OF GREATER MERCER COUNTY
Entity type:Organization
Organization Name:JEWISH FAMILY & CHILDREN'S SERVICE OF GREATER MERCER COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-987-8100
Mailing Address - Street 1:707 ALEXANDER ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:609-987-8100
Mailing Address - Fax:609-987-0574
Practice Address - Street 1:707 ALEXANDER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6331
Practice Address - Country:US
Practice Address - Phone:609-987-8100
Practice Address - Fax:609-987-0574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008585001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ672207Medicare ID - Type Unspecified