Provider Demographics
NPI:1730425646
Name:UJA-ADDRESPITE SERVICES
Entity type:Organization
Organization Name:UJA-ADDRESPITE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-457-0058
Mailing Address - Street 1:190 MOORE ST
Mailing Address - Street 2:SUITE 272
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7424
Mailing Address - Country:US
Mailing Address - Phone:201-457-0058
Mailing Address - Fax:201-457-0025
Practice Address - Street 1:190 MOORE ST
Practice Address - Street 2:SUITE 272
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-7424
Practice Address - Country:US
Practice Address - Phone:201-457-0058
Practice Address - Fax:201-457-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable