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General NPI Number Information
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NPI Number | 1619667797
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Entity Type | Organization
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Legal Business Name | SPECIAL PARENT ADVOCACY GROUP A NJ NON PROFIT CORPORATION
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 685 E 34TH ST
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City | PATERSON
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State | NJ
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Zip | 07513-1805
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Country | US
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Telephone | 201-509-8961
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Fax |
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Provider Business Mailing Address
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Address Line | 1 US HIGHWAY 46W SUITE 105
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407
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Country | US
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Telephone | 201-509-8961
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NICOLE ANN WHITFIELD
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Credential |
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Telephone | 201-509-8961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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