Healthcare Provider Details

I. General information

NPI: 1154899052
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA - GREATER NEW YORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 WOODLAND AVE
PLAINFIELD NJ
07062-1835
US

IV. Provider business mailing address

205 W MILTON AVE
RAHWAY NJ
07065-3203
US

V. Phone/Fax

Practice location:
  • Phone: 732-827-2472
  • Fax:
Mailing address:
  • Phone: 732-827-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
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: ORIETTA DIANNE BREWER
Title or Position: EXEC. ASST. CEO
Credential:
Phone: 212-496-4303