Healthcare Provider Details

I. General information

NPI: 1194648055
Provider Name (Legal Business Name): URBAN LEAGUE OF UNION COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 E JERSEY ST STE 515
ELIZABETH NJ
07201-2444
US

IV. Provider business mailing address

1139 E JERSEY ST STE 515
ELIZABETH NJ
07201-2444
US

V. Phone/Fax

Practice location:
  • Phone: 908-351-7200
  • Fax:
Mailing address:
  • Phone: 908-351-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL ORR
Title or Position: CEO
Credential:
Phone: 908-351-7200