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NPI Code Detail

MEDICARE: THE ARC OF BERGENA AND PASSAIC COUNTIES, INC.

MEDICARE: THE ARC OF BERGENA AND PASSAIC COUNTIES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1376058867
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE ARC OF BERGENA AND PASSAIC COUNTIES, INC.
Provider Business Mailing Address
First Line : 223 MOORE ST
Second Line :
City : HACKENSACK
State : NJ
Zip : 07601-7402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9 VERNON CT
Second Line :
City : WAYNE
State : NJ
Zip : 07470-6544
Country : US
Telephone Number : 862-221-9558
Fax Number :
Authorized Official
Title or Position : CFO/VICE PRESIDENT
Name : CATHERINE PESCATORE
Credential :
Telephone Number : 201-343-0322
Provider Enumeration Date : 12/06/2017
Last Update Date : 12/06/2017

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Directions to “THE ARC OF BERGENA AND PASSAIC COUNTIES, INC. ” Practice Location

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