Provider Demographics
NPI:1023232246
Name:HOUSING AUTHORITY OF THE CITY OF MILLVILLE
Entity type:Organization
Organization Name:HOUSING AUTHORITY OF THE CITY OF MILLVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHARD
Authorized Official - Suffix:
Authorized Official - Credentials:NJCALA
Authorized Official - Phone:856-825-8869
Mailing Address - Street 1:100 RIVERSIDE DR.
Mailing Address - Street 2:BOX 1-G
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332
Mailing Address - Country:US
Mailing Address - Phone:856-825-8869
Mailing Address - Fax:856-293-1294
Practice Address - Street 1:100 RIVERSIDE DR
Practice Address - Street 2:BOX 1-G
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332
Practice Address - Country:US
Practice Address - Phone:856-825-8869
Practice Address - Fax:856-825-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25A200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000931Medicaid