Healthcare Provider Details

I. General information

NPI: 1508777145
Provider Name (Legal Business Name): UNIVERSAL REHABILITATION AND FITNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 ARVERNE RD
WEST ORANGE NJ
07052-3102
US

IV. Provider business mailing address

15 MICROLAB RD STE 17
LIVINGSTON NJ
07039-1699
US

V. Phone/Fax

Practice location:
  • Phone: 973-992-8181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCUDILLO
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 973-992-8181