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NPI Code Detail

MEDICARE: THE NORTH WARD CENTER, INC,

MEDICARE: THE NORTH WARD CENTER, INC,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1316420755
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE NORTH WARD CENTER, INC,
Provider Business Mailing Address
First Line : 346 MOUNT PROSPECT AVE
Second Line :
City : NEWARK
State : NJ
Zip : 07104-2106
Country : US
Telephone Number : 973-481-0415
Fax Number :
Provider Business Practice Location Address
First Line : 346 MOUNT PROSPECT AVE
Second Line :
City : NEWARK
State : NJ
Zip : 07104-2106
Country : US
Telephone Number : 973-481-0415
Fax Number :
Authorized Official
Title or Position : CFO
Name : SUNG YI
Credential :
Telephone Number : 973-481-0415
Provider Enumeration Date : 09/12/2018
Last Update Date : 11/07/2018

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