Healthcare Provider Details

I. General information

NPI: 1568967073
Provider Name (Legal Business Name): EDUCATIONAL PARTNERSHIP FOR INCLUSIVE COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 MIDLAND AVE
SADDLE BROOK NJ
07663-6411
US

IV. Provider business mailing address

238 N FARVIEW AVE
PARAMUS NJ
07652-3244
US

V. Phone/Fax

Practice location:
  • Phone: 201-300-1960
  • Fax: 201-300-0395
Mailing address:
  • Phone: 201-576-0600
  • Fax: 201-576-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER F GERHARDT
Title or Position: EXECUTIVE DIRECTOR
Credential: ED.D.
Phone: 201-300-1960