Provider Demographics
NPI:1033735808
Name:EDUCATIONAL CENTER FOR THE DISABLES. N J NON PROFIT
Entity Type:Organization
Organization Name:EDUCATIONAL CENTER FOR THE DISABLES. N J NON PROFIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:AWERE
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:862-588-7352
Mailing Address - Street 1:6501 E LIVINGSTON AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:512 UNION AVE APT B2
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2863
Practice Address - Country:US
Practice Address - Phone:862-588-7352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home