Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
New Lisbon Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANENE M HAWK MASTERS IN MGMT (ASSISTANT BUSINESS MANAGER)
(609) 894-4001
Entity
Organization
Contact information
Practice address
RTE 72 EAST, NEW LISBON, NJ 08064-0130
(609) 894-4001
(609) 726-1293
Mailing address
HWY 72 EAST, NEW LISBON, NJ 08064-0130
(609) 894-4001
(609) 726-1293
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4467001
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
528585
MEDICARE BILLING GROUP
NJ
Enumeration date
06/15/2006
Last updated
10/04/2011
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