Healthcare Provider Details

I. General information

NPI: 1568366656
Provider Name (Legal Business Name): CASA LAMARCHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 ROLLINS AVE
CLIFTON NJ
07011-3517
US

IV. Provider business mailing address

66 ROLLINS AVE
CLIFTON NJ
07011-3517
US

V. Phone/Fax

Practice location:
  • Phone: 862-703-9791
  • Fax:
Mailing address:
  • Phone: 862-703-9791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAROLINA A CAMPBELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 862-703-9791