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General NPI Number Information
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NPI Number | 1033735808
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Entity Type | Organization
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Legal Business Name | EDUCATIONAL CENTER FOR THE DISABLES. N J NON PROFIT
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 512 UNION AVE APT B2
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City | IRVINGTON
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State | NJ
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Zip | 07111-2863
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Country | US
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Telephone | 862-588-7352
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 E LIVINGSTON AVE STE 5
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-3561
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN AWERE WEBSTER
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Credential | MA
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Telephone | 862-588-7352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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