Provider Demographics
NPI:1992108690
Name:TWIN OAKS COMMUNITY CENTER
Entity type:Organization
Organization Name:TWIN OAKS COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUB RESPITE WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHERA
Authorized Official - Middle Name:DENENE
Authorized Official - Last Name:LITTLEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-262-8668
Mailing Address - Street 1:513 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-2906
Mailing Address - Country:US
Mailing Address - Phone:856-262-8668
Mailing Address - Fax:
Practice Address - Street 1:770 WOODLANE RD SUITE 35
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060
Practice Address - Country:US
Practice Address - Phone:609-267-5928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid