Provider Demographics
NPI:1962754150
Name:SMALL & ASSOCIATES, INC.
Entity type:Organization
Organization Name:SMALL & ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CRC
Authorized Official - Phone:973-533-1662
Mailing Address - Street 1:5 REGENT ST STE 528
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1621
Mailing Address - Country:US
Mailing Address - Phone:973-533-1662
Mailing Address - Fax:973-533-3387
Practice Address - Street 1:5 REGENT ST STE 528
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1621
Practice Address - Country:US
Practice Address - Phone:973-533-1662
Practice Address - Fax:973-533-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services