Provider Demographics
NPI:1861750168
Name:GENERATIONS INC.
Entity type:Organization
Organization Name:GENERATIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-782-6746
Mailing Address - Street 1:10 FOSTER AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:GIBBSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08026-1162
Mailing Address - Country:US
Mailing Address - Phone:856-782-6763
Mailing Address - Fax:856-782-6796
Practice Address - Street 1:113 WHITE HORSE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-435-1023
Practice Address - Fax:856-435-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NJ2000019-05251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0072249Medicaid