Provider Demographics
NPI:1972059822
Name:MALVERN INSTITUTE HUNTERDON COUNTY,LLC
Entity type:Organization
Organization Name:MALVERN INSTITUTE HUNTERDON COUNTY,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:KARDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-840-1192
Mailing Address - Street 1:521 PLYMOUTH RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1657
Mailing Address - Country:US
Mailing Address - Phone:215-840-1192
Mailing Address - Fax:
Practice Address - Street 1:200 SANITORIUM RD.
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826
Practice Address - Country:US
Practice Address - Phone:215-840-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIONS COMPANIES,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility