Provider Demographics
NPI:1225661051
Name:UNITED COMMUNITY SUPPORT
Entity Type:Organization
Organization Name:UNITED COMMUNITY SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:EBEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-314-7920
Mailing Address - Street 1:66 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1028
Mailing Address - Country:US
Mailing Address - Phone:201-314-7920
Mailing Address - Fax:
Practice Address - Street 1:66 8TH ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1028
Practice Address - Country:US
Practice Address - Phone:201-314-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services