Healthcare Provider Details

I. General information

NPI: 1720925621
Provider Name (Legal Business Name): COMMUNITY ACCESS UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 NEWARK AVE APT C
ELIZABETH NJ
07208-3500
US

IV. Provider business mailing address

80 W GRAND ST
ELIZABETH NJ
07202-1471
US

V. Phone/Fax

Practice location:
  • Phone: 908-354-3040
  • Fax:
Mailing address:
  • Phone: 908-354-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VANESSA YALAKIDIS
Title or Position: AED OF EHR SERVICES
Credential:
Phone: 908-354-3040