Provider Demographics
NPI:1487163952
Name:PLAID HOUSE INC.
Entity type:Organization
Organization Name:PLAID HOUSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-267-4008
Mailing Address - Street 1:54 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5469
Mailing Address - Country:US
Mailing Address - Phone:973-267-4008
Mailing Address - Fax:873-267-7836
Practice Address - Street 1:54 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5469
Practice Address - Country:US
Practice Address - Phone:973-267-4008
Practice Address - Fax:873-267-7836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:973 267 4008
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0523691Medicaid