Provider Demographics
NPI:1568982882
Name:CENTER FOR HUMANISTIC CHANGE OF NJ, INC.
Entity type:Organization
Organization Name:CENTER FOR HUMANISTIC CHANGE OF NJ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-691-3488
Mailing Address - Street 1:12 US HIGHWAY 206
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-3269
Mailing Address - Country:US
Mailing Address - Phone:973-691-3488
Mailing Address - Fax:
Practice Address - Street 1:101 CHRISTOPHER ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1703
Practice Address - Country:US
Practice Address - Phone:908-979-3435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities