Organization Name: | CEREBRAL PALSY OF NORTH JERSEY |
NPI Number: | 1912355686 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PURNA RODMAN CONARE (CEO) |
Mailing Address: | 415 Hamburg Tpke Building C-1 & C-2 Wayne |
State: | NJ US |
Postal Code: | 074702129 |
Phone Number: | 9739569040 |
Fax Number: | 9739569404 |
NPI Enumeration Date: | 06/02/2016 |
NPI Last Update Date: | 06/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |