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Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
New Lisbon Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANENE M HAWK MASTERS IN MGMT (ASSISTANT BUSINESS MANAGER)
(609) 894-4001
Entity
Organization
Contact information
Practice address
RTE 72 EAST, NEW LISBON, NJ 08064-0130
(609) 894-4001
(609) 726-1293
Mailing address
HWY 72 EAST, NEW LISBON, NJ 08064-0130
(609) 894-4001
(609) 726-1293
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4467001
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
528585
MEDICARE BILLING GROUP
NJ
Enumeration date
06/15/2006
Last updated
10/04/2011
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