Provider Demographics
NPI:1518211283
Name:PARENT ASSOCIATION FOR DISABLE CHILDREN,ADULT&SENIOR
Entity type:Organization
Organization Name:PARENT ASSOCIATION FOR DISABLE CHILDREN,ADULT&SENIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:977-345-4998
Mailing Address - Street 1:794 MADISON AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-2409
Mailing Address - Country:US
Mailing Address - Phone:973-345-4998
Mailing Address - Fax:973-345-4998
Practice Address - Street 1:778 MADISON AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2409
Practice Address - Country:US
Practice Address - Phone:973-345-4998
Practice Address - Fax:973-345-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility