Provider Demographics
NPI:1992235675
Name:PENNINGTON ADULT LIVING SERVICES
Entity type:Organization
Organization Name:PENNINGTON ADULT LIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:NERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-529-6010
Mailing Address - Street 1:46 YARD RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3905
Mailing Address - Country:US
Mailing Address - Phone:609-529-6010
Mailing Address - Fax:609-529-6010
Practice Address - Street 1:46 YARD RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-3905
Practice Address - Country:US
Practice Address - Phone:609-529-6010
Practice Address - Fax:609-529-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty