# STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL

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

## Provider details

- **NPI number:** 1588607725
- **Authorized official:** SARAH RUSSELL (BUSINESS MANAGER)
- **Authorized official phone:** (856) 285-2266

## Contact information

- **Practice address:** 1676 E LANDIS AVE, VINELAND, NJ 08362-1513
- **Practice address phone:** (856) 696-6000
- **Practice address fax:** (856) 696-6056
- **Mailing address:** PO BOX 1513, VINELAND, NJ 08362-1513
- **Mailing address phone:** (856) 696-6000
- **Mailing address fax:** (856) 696-6056

## Taxonomy

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

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 07/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4474201 | — | NJ |
| 01 | — | 528583 | PROVIDER GROUP | NJ |