Provider Demographics
NPI:1972328714
Name:CHILD AND FAMILY DEVELOPMENT
Entity type:Organization
Organization Name:CHILD AND FAMILY DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STGERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, DIR-E
Authorized Official - Phone:203-927-1072
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-0203
Mailing Address - Country:US
Mailing Address - Phone:203-927-1072
Mailing Address - Fax:
Practice Address - Street 1:101 SEQUOIA DR
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2308
Practice Address - Country:US
Practice Address - Phone:203-927-1072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty