Organization
DUNGARVIN NEW JERSEY, LLC-ANTONIO
Active
Parent organization
DUNGARVIN GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DUNGARVIN GROUP, INC.
Authorized official
LORI KRESS (CEO)
(651) 699-0206
Entity
Organization
Contact information
Practice address
1066 ANTONIO DR, NORTH BRUNSWICK, NJ 08902
(732) 565-0016
Mailing address
1543 STATE ROUTE 27, SUITE 24, SOMERSET, NJ 08873-4015
(732) 463-7227
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0494275
—
NJ
Enumeration date
05/11/2016
Last updated
04/27/2023
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