Healthcare Provider Details

I. General information

NPI: 1972997310
Provider Name (Legal Business Name): 7TH & MADISON EXTENSIONS OF EMPOWERMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 WARREN ST STE 223
NEWARK NJ
07103-3568
US

IV. Provider business mailing address

PO BOX 372
CHATHAM NJ
07928-0372
US

V. Phone/Fax

Practice location:
  • Phone: 800-936-3256
  • Fax: 877-413-9752
Mailing address:
  • Phone: 800-936-3256
  • Fax: 800-936-3256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: AMANDA WEISS
Title or Position: ADMINISTRATOR
Credential:
Phone: 800-936-3256