Organization
SERV CENTERS OF NEW JERSEY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY VAN NOSTRAND (CEO)
(609) 406-0100
Entity
Organization
Contact information
Practice address
111 NORTH AVENUE WEST, CRANFORD, NJ 07016
(908) 276-3359
(609) 276-2472
Mailing address
380 SCOTCH RD, W TRENTON, NJ 08628
(609) 406-0100
(609) 406-0307
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
4040
NJ
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
50004X42Y207
NJ
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
50004X42Y307
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8535906
—
NJ
Enumeration date
12/14/2006
Last updated
08/22/2020
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