Provider Demographics
NPI:1558983155
Name:WOMEN'S LEAGUE COMMUNITY RESIDENCES, INC.
Entity Type:Organization
Organization Name:WOMEN'S LEAGUE COMMUNITY RESIDENCES, INC.
Other - Org Name:MAKOR DISABILITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-853-0900
Mailing Address - Street 1:265 CEDAR LN FL 2
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3444
Mailing Address - Country:US
Mailing Address - Phone:201-381-1450
Mailing Address - Fax:
Practice Address - Street 1:265 CEDAR LN FL 2
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3444
Practice Address - Country:US
Practice Address - Phone:201-381-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities