Provider Demographics
NPI:1588703177
Name:CRANFORD CENTER FOR HUMAN DEVELOPMENT
Entity type:Organization
Organization Name:CRANFORD CENTER FOR HUMAN DEVELOPMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN FOSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:908-276-0590
Mailing Address - Street 1:1961 RARITAN ROAD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2932
Mailing Address - Country:US
Mailing Address - Phone:908-276-0590
Mailing Address - Fax:908-276-6769
Practice Address - Street 1:1961 RARITAN ROAD
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-2932
Practice Address - Country:US
Practice Address - Phone:908-276-0590
Practice Address - Fax:908-276-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
026614Medicare ID - Type Unspecified