Provider Demographics
NPI:1912355686
Name:CEREBRAL PALSY OF NORTH JERSEY
Entity type:Organization
Organization Name:CEREBRAL PALSY OF NORTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-821-8107
Mailing Address - Street 1:220 S ORANGE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5804
Mailing Address - Country:US
Mailing Address - Phone:973-763-9900
Mailing Address - Fax:973-763-9905
Practice Address - Street 1:415 HAMBURG TPKE
Practice Address - Street 2:BUILDING C-1 & C-2
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2129
Practice Address - Country:US
Practice Address - Phone:973-956-9040
Practice Address - Fax:973-956-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child