Provider Demographics
NPI:1619446317
Name:COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Entity Type:Organization
Organization Name:COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST FISCAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-622-3570
Mailing Address - Street 1:35 LINCOLN PARK
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-2390
Mailing Address - Country:US
Mailing Address - Phone:973-353-6285
Mailing Address - Fax:973-622-4550
Practice Address - Street 1:595 COUNTY AVE
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2605
Practice Address - Country:US
Practice Address - Phone:201-392-9669
Practice Address - Fax:201-392-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility