Provider Demographics
NPI:1205353448
Name:UNITY FOR DEVELOPMENTAL DISABILITIES
Entity type:Organization
Organization Name:UNITY FOR DEVELOPMENTAL DISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHON
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-856-4404
Mailing Address - Street 1:212 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2434
Mailing Address - Country:US
Mailing Address - Phone:973-856-4404
Mailing Address - Fax:
Practice Address - Street 1:212 SUMMIT AVE.
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865
Practice Address - Country:US
Practice Address - Phone:973-856-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management