| Organization Name: | SENIOR SPIRIT OF ROSELLE PARK |
| NPI Number: | 1245384916 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ENRIQUE R. GIORDANO (MANAGING MEMBER) |
| Mailing Address: | 430 East Westfield Avenue Roselle Park |
| State: | NJ US |
| Postal Code: | 07204 |
| Phone Number: | 9082419393 |
| Fax Number: | 9086201899 |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 05/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 908117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |