Provider Demographics
NPI:1669797916
Name:HEIGHTENED INDEPENDENCE AND PROGRESS HUDSON BRANCH
Entity type:Organization
Organization Name:HEIGHTENED INDEPENDENCE AND PROGRESS HUDSON BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, HUDSON BRANCH
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:201-533-4407
Mailing Address - Street 1:26 JOURNAL SQ
Mailing Address - Street 2:SUITE 602
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4102
Mailing Address - Country:US
Mailing Address - Phone:201-522-4407
Mailing Address - Fax:201-533-4421
Practice Address - Street 1:26 JOURNAL SQ
Practice Address - Street 2:SUITE 602
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4102
Practice Address - Country:US
Practice Address - Phone:201-522-4407
Practice Address - Fax:201-533-4421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEIGHTENED INDEPENDENCE AND PROGRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management