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Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
Vineland Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH RUSSELL (BUSINESS MANAGER)
(856) 285-2266
Entity
Organization
Contact information
Practice address
1676 E LANDIS AVE, VINELAND, NJ 08362-1513
(856) 696-6000
(856) 696-6056
Mailing address
PO BOX 1513, VINELAND, NJ 08362-1513
(856) 696-6000
(856) 696-6056
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4474201
—
NJ
01
—
528583
PROVIDER GROUP
NJ
Enumeration date
06/14/2006
Last updated
07/09/2024
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