Healthcare Provider Details

I. General information

NPI: 1972290260
Provider Name (Legal Business Name): GOD IS ABLE REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 RUTGERS AVE
HILLSIDE NJ
07205-2009
US

IV. Provider business mailing address

360 RUTGERS AVE
HILLSIDE NJ
07205-2009
US

V. Phone/Fax

Practice location:
  • Phone: 973-856-0235
  • Fax:
Mailing address:
  • Phone: 973-856-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES ALAETO
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: NP
Phone: 973-856-0235