Provider Demographics
NPI:1174997340
Name:CINNAMINSON ATS
Entity type:Organization
Organization Name:CINNAMINSON ATS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:856-456-2022
Mailing Address - Street 1:1204 SHERWIN WILLIAMS PLAZA RT. 130 N
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-6360
Mailing Address - Country:US
Mailing Address - Phone:856-829-5741
Mailing Address - Fax:856-829-5305
Practice Address - Street 1:1204 SHERWIN WILLIAMS PLAZA RT. 130 N SUITE 14 AND 15
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-6360
Practice Address - Country:US
Practice Address - Phone:856-829-5741
Practice Address - Fax:856-829-5305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KELSCH ASSOCIATES NJ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid