Provider Demographics
NPI:1639646938
Name:COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Entity Type:Organization
Organization Name:COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Other - Org Name:NEWARK LONG TERM
Other - Org Type:Other Name
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 1:61 LINCOLN PARK
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2390
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-25
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility