Healthcare Provider Details

I. General information

NPI: 1255277638
Provider Name (Legal Business Name): URBAN LEAGUE OF ESSEX COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 CENTRAL AVE
NEWARK NJ
07107-1430
US

IV. Provider business mailing address

508 CENTRAL AVE
NEWARK NJ
07107-1430
US

V. Phone/Fax

Practice location:
  • Phone: 973-624-9535
  • Fax: 973-624-9597
Mailing address:
  • Phone: 973-624-9535
  • Fax: 973-624-9597

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 Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VIVIAN COX FRASER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 973-624-9535