Provider Demographics
| NPI: | 1881034767 |
|---|---|
| Name: | TWIN OAKS COMMUNITY SERVICES, INC |
| Entity type: | Organization |
| Organization Name: | TWIN OAKS COMMUNITY SERVICES, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | QINDI |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SHI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 609-267-5928 |
| Mailing Address - Street 1: | 770 WOODLANE RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WESTAMPTON |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 08060-3804 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 239 CHESTNUT AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | EVESHAM |
| Practice Address - State: | NJ |
| Practice Address - Zip Code: | 08053-7147 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 609-267-5928 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2013-06-25 |
| Last Update Date: | 2013-06-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NJ | PENDING | Medicaid |