Healthcare Provider Details

I. General information

NPI: 1346585940
Provider Name (Legal Business Name): HEIGHTENED INDEPENDENCE AND PROGRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MAIN ST SUITE 120
HACKENSACK NJ
07601-7052
US

IV. Provider business mailing address

131 MAIN ST SUITE 120
HACKENSACK NJ
07601-7052
US

V. Phone/Fax

Practice location:
  • Phone: 201-996-9100
  • Fax: 201-996-9422
Mailing address:
  • Phone: 201-996-9100
  • Fax: 201-996-9422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. EILEEN GOFF
Title or Position: PRESIDENT/CEO
Credential: CSW
Phone: 201-996-9100