Organization
NJ ECC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN WILLIS (CEO)
(201) 819-9061
Entity
Organization
Contact information
Practice address
30-34 OKNER PKWY, LIVINGSTON, NJ 07039-1649
(304) 282-1310
Mailing address
30-34 OKNER PKWY, LIVINGSTON, NJ 07039-1649
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0612561
—
NJ
Enumeration date
11/13/2020
Last updated
11/13/2020
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