Provider Demographics
NPI:1548689086
Name:NEW JERSEY ADULT MEDICAL DAY CARE CENTER II
Entity type:Organization
Organization Name:NEW JERSEY ADULT MEDICAL DAY CARE CENTER II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-736-5301
Mailing Address - Street 1:290 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-578-2815
Mailing Address - Fax:973-589-0787
Practice Address - Street 1:290 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-578-2815
Practice Address - Fax:973-589-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health