1467667683 NPI number — COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS

Table of content: (NPI 1467667683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467667683 NPI number — COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CURA, INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467667683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 LINCOLN PARK
Provider Second Line Business Mailing Address:
P.O. BOX 180
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07101-0180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-622-3570
Provider Business Mailing Address Fax Number:
973-645-4550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
729 E LANDIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VINELAND
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08360-8005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-622-3570
Provider Business Practice Location Address Fax Number:
973-645-4550
Provider Enumeration Date:
05/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PLAZA
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
PRESIDENT, CEO
Authorized Official Telephone Number:
973-622-3570

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  324500000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7605609 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0507482 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7606303 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0507504 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7606001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".