Provider Demographics
NPI:1699363812
Name:UNITED COMMUNITY CORPORATION
Entity Type:Organization
Organization Name:UNITED COMMUNITY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MAINOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-642-0181
Mailing Address - Street 1:332 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2173
Mailing Address - Country:US
Mailing Address - Phone:973-642-0181
Mailing Address - Fax:
Practice Address - Street 1:31 FULTON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-4506
Practice Address - Country:US
Practice Address - Phone:973-642-0181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility