Healthcare Provider Details

I. General information

NPI: 1083890867
Provider Name (Legal Business Name): COMMUNITY OPTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 5TH AVE SUITE 1207
NEW YORK NY
10118
US

IV. Provider business mailing address

16 FARBER RD
PRINCETON NJ
08540-5913
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-9110
  • Fax: 212-227-9115
Mailing address:
  • Phone: 609-951-9900
  • Fax: 609-799-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT STACK
Title or Position: PRESIDENT
Credential:
Phone: 609-951-9900