# STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** New Lisbon Developmental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255375929
- **Authorized official:** MRS. JANENE M HAWK MASTERS IN MGMT (ASSISTANT BUSINESS MANAGER)
- **Authorized official phone:** (609) 894-4001

## Contact information

- **Practice address:** RTE 72 EAST, NEW LISBON, NJ 08064-0130
- **Practice address phone:** (609) 894-4001
- **Practice address fax:** (609) 726-1293
- **Mailing address:** HWY 72 EAST, NEW LISBON, NJ 08064-0130
- **Mailing address phone:** (609) 894-4001
- **Mailing address fax:** (609) 726-1293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 4467001 | NJ | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 10/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 528585 | MEDICARE BILLING GROUP | NJ |