Healthcare Provider Details

I. General information

NPI: 1891344388
Provider Name (Legal Business Name): COLLEGE ACHIEVE CENTRAL CHARTER SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 EMERSON AVE
PLAINFIELD NJ
07062-1701
US

IV. Provider business mailing address

365 EMERSON AVE
PLAINFIELD NJ
07062-1701
US

V. Phone/Fax

Practice location:
  • Phone: 908-668-1000
  • Fax: 908-441-9877
Mailing address:
  • Phone: 908-668-1000
  • Fax: 908-441-9877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. ALLISON FOX-BRELAND
Title or Position: DIRECTOR OF ADMINISTRATIVE SERVICES
Credential:
Phone: 908-668-1000