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General NPI Number Information
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NPI Number | 1780063248
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Entity Type | Organization
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Legal Business Name | LADACIN NETWORK
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 170 OBERLIN AVE N SUITE 8
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4548
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Country | US
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Telephone | 732-905-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 KNEELEY BLVD
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City | OCEAN
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State | NJ
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Zip | 07712-7622
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Country | US
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Telephone | 732-493-5900
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Fax | 732-493-5980
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PATRICIA CARLESIMO
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Credential |
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Telephone | 732-493-5900
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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 | NJ
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