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Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
North Jersey Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE WERKHEISER (CEO)
(973) 890-4540
Entity
Organization
Contact information
Practice address
169 MINNISINK RD, TOTOWA, NJ 07512-1803
(973) 256-1700
(973) 256-7651
Mailing address
PO BOX 169, TOTOWA, NJ 07511-0169
(973) 256-1700
(973) 256-7651
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
—
4497601
—
NJ
01
—
528584
MEDICARE BILLING GROUP NO
NJ
Enumeration date
06/03/2006
Last updated
03/27/2008
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