Healthcare Provider Details

I. General information

NPI: 1295205839
Provider Name (Legal Business Name): OCCUPATIONAL CENTER OF UNION COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 COX ST
ROSELLE NJ
07203-1797
US

IV. Provider business mailing address

301 COX ST
ROSELLE NJ
07203-1797
US

V. Phone/Fax

Practice location:
  • Phone: 908-241-7200
  • Fax:
Mailing address:
  • Phone: 908-241-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELE N FORD
Title or Position: PRESIDENT CEO
Credential: LPC
Phone: 908-241-7200