Healthcare Provider Details

I. General information

NPI: 1356872311
Provider Name (Legal Business Name): THE LEARNING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 SCOLES AVE
CLIFTON NJ
07012-1125
US

IV. Provider business mailing address

199 SCOLES AVE
CLIFTON NJ
07012-1125
US

V. Phone/Fax

Practice location:
  • Phone: 973-685-9554
  • Fax: 973-685-9556
Mailing address:
  • Phone: 973-685-9554
  • Fax: 973-685-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. SACHA MAXIMILIEN POULIOT
Title or Position: ASSISTANT DIRECTOR
Credential: M.S.
Phone: 201-341-2339