National Provider Identifier Database

DUNGARVIN NEW JERSEY LLC WHITEHEAD ONE
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-WHITEHEAD ONE
1015 WHITEHEAD ROAD EXT
APT. 108
EWING TOWNSHIP, NJ08638
Phone: 609-771-0564
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-WHITEHEAD ONE

NPI Number 1497104905
Legal business name
LBN
DUNGARVIN NEW JERSEY, LLC-WHITEHEAD ONE
Authorized official LORI KRESS - (CEO)
Entity Organization
Organization subpart Yes
Enumeration date 06/06/2016
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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