Provider Demographics
NPI:1730431933
Name:THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC.
Entity type:Organization
Organization Name:THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-629-7939
Mailing Address - Street 1:205 ROBIN RD
Mailing Address - Street 2:SUITE 122
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1449
Mailing Address - Country:US
Mailing Address - Phone:201-262-4021
Mailing Address - Fax:201-262-0260
Practice Address - Street 1:205 ROBIN RD
Practice Address - Street 2:SUITE 122
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1449
Practice Address - Country:US
Practice Address - Phone:201-262-4021
Practice Address - Fax:201-262-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities