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General NPI Number Information
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NPI Number | 1528473709
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Entity Type | Organization
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Legal Business Name | OPEN DOORS UNLIMITED
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 235 TERRACE LAKE DR
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City | BUTLER
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State | NJ
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Zip | 07405-3253
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Country | US
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Telephone | 201-621-3372
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Fax | 973-850-6005
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Provider Business Mailing Address
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Address Line | 235 TERRACE LAKE DR
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City | BUTLER
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State | NJ
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Zip | 07405-3253
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Country | US
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Telephone | 201-621-3372
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Fax | 973-850-6005
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Authorized Official
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Title or Position | RN MANAGER
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Name | MRS. ERICA SUSAN GOODMAN
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Credential | RN
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Telephone | 201-621-3372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 26NO11190600
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License Number State | NJ
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