Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
Vineland Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH RUSSELL (BUSINESS MANAGER)
(856) 285-2266
Entity
Organization
Contact information
Practice address
1676 E LANDIS AVE, VINELAND, NJ 08362-1513
(856) 696-6000
(856) 696-6056
Mailing address
PO BOX 1513, VINELAND, NJ 08362-1513
(856) 696-6000
(856) 696-6056
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4474201
—
NJ
01
—
528583
PROVIDER GROUP
NJ
Enumeration date
06/14/2006
Last updated
07/09/2024
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