National Provider Identifier Database

DUNGARVIN NEW JERSEY LLC RANCOCAS DAY PROGRAM
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM
1000 REV DR MARTIN LUTHER KING JR DR
WILLINGBORO, NJ08046
Phone: 609-871-2752
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM

NPI Number 1174976963
Legal business name
LBN
DUNGARVIN NEW JERSEY, LLC-RANCOCAS DAY PROGRAM
Authorized official LORI KRESS - (CEO)
Entity Organization
Organization subpart Yes
Enumeration date 07/18/2016
Last updated 04/27/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • NJ Medicaid: 0494275

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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