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General NPI Number Information
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NPI Number | 1821892555
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Entity Type | Organization
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Legal Business Name | LA CASA DE DON PEDRO
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 23 BROADWAY
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City | NEWARK
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State | NJ
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Zip | 07104-3305
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Country | US
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Telephone | 973-483-2703
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Fax |
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Provider Business Mailing Address
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Address Line | 75 PARK AVE
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City | NEWARK
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State | NJ
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Zip | 07104-1034
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Country | US
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Telephone | 973-482-8312
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | PETER ROSARIO
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Credential |
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Telephone | 973-482-8312
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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 |
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License Number State |
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