# WILLOWGLEN ACADEMY-NJ INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164684148
- **Authorized official:** MR. RICHARD KOCHMAN (ASSOCIATE DIRECTOR OF FISCAL AFFAIR)
- **Authorized official phone:** (973) 579-3700

## Contact information

- **Practice address:** 8 WILSON DR, SPARTA, NJ 07871-3400
- **Practice address phone:** (973) 579-3700
- **Practice address fax:** (973) 579-1786
- **Mailing address:** 8 WILSON DR, SPARTA, NJ 07871-3400
- **Mailing address phone:** (973) 579-3700
- **Mailing address fax:** (973) 579-1786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/30/2008
- **Last updated:** 06/30/2008