| St. Timothy's Group Home | |
|
399 Heywood Ave Orange NJ 07050-2006 | |
| (973) 673-4562 | |
| (973) 673-3238 |
| Full Name | St. Timothy's Group Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 399 Heywood Ave, Orange, New Jersey |
| Authorized Official Name and Position | Dorothy Knauer (CEO) |
| Authorized Official Contact | 9736212273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Timothy's Group Home 25 James St Newark NJ 07102-2001 Ph: (973) 621-2273 | St. Timothy's Group Home 399 Heywood Ave Orange NJ 07050-2006 Ph: (973) 673-4562 |
| NPI Number | 1124201462 |
|---|---|
| Provider Enumeration Date | 12/10/2007 |
| Last Update Date | 12/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124201462 | NPI | - | NPPES |
| 8488509 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2200 (New Jersey) | Primary |
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