Provider Demographics
NPI:1699564443
Name:THE PUERTO RICAN ACTION COMMITTEE OF SOUTHERN NEW JERSEY
Entity type:Organization
Organization Name:THE PUERTO RICAN ACTION COMMITTEE OF SOUTHERN NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-405-6753
Mailing Address - Street 1:818 E LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8021
Mailing Address - Country:US
Mailing Address - Phone:856-405-6753
Mailing Address - Fax:
Practice Address - Street 1:818 E LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8021
Practice Address - Country:US
Practice Address - Phone:856-405-6753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management