Provider Demographics
NPI:1730552647
Name:UBEFITLLC
Entity type:Organization
Organization Name:UBEFITLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCADC
Authorized Official - Phone:908-688-4462
Mailing Address - Street 1:360 STILES ST
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1329
Mailing Address - Country:US
Mailing Address - Phone:908-265-0916
Mailing Address - Fax:908-688-7959
Practice Address - Street 1:360 STILES ST
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1329
Practice Address - Country:US
Practice Address - Phone:908-265-0916
Practice Address - Fax:908-688-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty