Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
Other names
North Jersey Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE WERKHEISER (CEO)
(973) 890-4540
Entity
Organization
Contact information
Practice address
169 MINNISINK RD, TOTOWA, NJ 07512-1803
(973) 256-1700
(973) 256-7651
Mailing address
PO BOX 169, TOTOWA, NJ 07511-0169
(973) 256-1700
(973) 256-7651
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
—
4497601
—
NJ
01
—
528584
MEDICARE BILLING GROUP NO
NJ
Enumeration date
06/03/2006
Last updated
03/27/2008
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