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General NPI Number Information
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NPI Number | 1083757256
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Entity Type | Organization
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Legal Business Name | CEREBRAL PALSY LEAGUE INC.
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 373 CLERMONT TER
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City | UNION
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State | NJ
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Zip | 07083-8073
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Country | US
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Telephone | 908-354-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 61 MYRTLE ST
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City | CRANFORD
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State | NJ
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Zip | 07016-3456
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Country | US
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Telephone | 908-709-1800
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. DEBRA WOLFEL
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Credential |
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Telephone | 908-709-1800
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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 | 080192
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License Number State | NJ
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