Provider Demographics
NPI:1376212506
Name:UNITY PLACE OF ATLANTIC COUNTY, LLC
Entity Type:Organization
Organization Name:UNITY PLACE OF ATLANTIC COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIYAHU
Authorized Official - Middle Name:
Authorized Official - Last Name:DANZIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-525-9877
Mailing Address - Street 1:758 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3031
Mailing Address - Country:US
Mailing Address - Phone:848-525-9877
Mailing Address - Fax:
Practice Address - Street 1:121 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1871
Practice Address - Country:US
Practice Address - Phone:609-704-1313
Practice Address - Fax:609-704-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health