MEDICARE: NICHOLAS LITERACY CENTER, LLC

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1770903106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICHOLAS LITERACY CENTER, LLC

Provider Business Mailing Address
First Line	:	150 MAPLE AVE
Second Line	:	SUITE 115
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-3407
Country	:	US
Telephone Number	:	732-742-4638
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 MAPLE AVE
Second Line	:	SUITE 115
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-3407
Country	:	US
Telephone Number	:	732-742-4638
Fax Number	:	877-635-5428

Authorized Official
Title or Position	:	CEO
Name	:	MS. JACQUELINE L SIMS
Credential	:
Telephone Number	:	732-742-4638

Provider Enumeration Date	:	04/24/2014
Last Update Date	:	04/24/2014

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