Organization
PEDIATRIC DAY HLTH CRT @ MILLH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J SALL (C.O.O.)
(856) 663-4044
Entity
Organization
Contact information
Practice address
325 JERSEY ST, TRENTON, NJ 08611-3113
(609) 396-2299
(609) 396-7611
Mailing address
1114 WYNNWOOD AVE, CHERRY HILL, NJ 08002-3256
(856) 663-4044
(856) 663-3444
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061212
—
NJ
Enumeration date
10/26/2006
Last updated
07/10/2007
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