Organization
WILLOWGLEN ACADEMY-NJ INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD KOCHMAN (ASSOCIATE DIRECTOR OF FISCAL AFFAIR)
(973) 579-3700
Entity
Organization
Contact information
Practice address
8 WILSON DR, SPARTA, NJ 07871-3400
(973) 579-3700
(973) 579-1786
Mailing address
8 WILSON DR, SPARTA, NJ 07871-3400
(973) 579-3700
(973) 579-1786
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8374104
—
NJ
Enumeration date
06/30/2008
Last updated
06/30/2008
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