Provider Demographics
NPI:1982139556
Name:CITY HILL CDC
Entity Type:Organization
Organization Name:CITY HILL CDC
Other - Org Name:STRIVE 4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMETRICE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CANTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-820-3986
Mailing Address - Street 1:10 HILL ST
Mailing Address - Street 2:#22A
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-5601
Mailing Address - Country:US
Mailing Address - Phone:973-820-3986
Mailing Address - Fax:
Practice Address - Street 1:703 S 12TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-1733
Practice Address - Country:US
Practice Address - Phone:973-820-3986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management