Organization
WILLOWGLEN ACADEMY - NEW JERSEY. INC.
Active
Organization
WILLOWGLEN ACADEMY - NEW JERSEY. INC.
Active
Parent organization
PHOENIX CARE SYSTEMS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX CARE SYSTEMS INC
Authorized official
DIONE GRANT (EXECUTIVE DIRECTOR)
(973) 579-3700
Entity
Organization
Contact information
Practice address
4 CENTER STREET, APT 36, SUSSEX, NJ 07461
(973) 579-3700
(973) 579-1786
Mailing address
8 WILSON DRIVE, SPARTA, NJ 07871
(973) 579-3700
(973) 579-1786
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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