Provider Demographics
NPI:1801386248
Name:OBLIGED-PRO1 INSTIDUTE LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:OBLIGED-PRO1 INSTIDUTE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAR
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:973-337-3656
Mailing Address - Street 1:66 N GROVE ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-4760
Mailing Address - Country:US
Mailing Address - Phone:973-337-3656
Mailing Address - Fax:
Practice Address - Street 1:66 N GROVE ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-4760
Practice Address - Country:US
Practice Address - Phone:973-337-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health