COMMUNITY ACTION FOR INDEPENDENT LIVING, INC.
NPI 1992186449
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in South Orange, NJ
- Organization
- Community Based Residential Treatment Fa...
About COMMUNITY ACTION FOR INDEPENDENT LIVING, INC.
This page provides the complete NPI Profile along with additional information for Community Action For Independent Living, Inc., a provider established in South Orange, New Jersey operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1992186449 assigned on June 2015. The practitioner's primary taxonomy code is 320900000X with license number GH201 (NJ). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's former legal business name is Interserv Services, Inc.. The authorized official of this NPI record is Michele Difabio (Controller)
- NPI
- 1992186449 Verify this NPI
- Provider Legal Name
- COMMUNITY ACTION FOR INDEPENDENT LIVING, INC.
- Other Organization Name
- INTERSERV SERVICES, INC.
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 34 S CENTRE ST SOUTH ORANGE, NJ 07079
- Location Phone
- (973) 763-7248
- Location Fax
- (973) 821-5497
- Mailing Address
- 1 CORNELL PKWY SPRINGFIELD, NJ 07081
- Mailing Phone
- (973) 564-7557
- Mailing Fax
- (973) 467-4255
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-10-2015
- Last Update Date
- 06-10-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320900000X
- Type
- Residential Treatment Facilities
- License No.
- GH201
- License State
- NJ
- Taxonomy Description
- A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
SOUTH ORANGE, NJ 07079
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992186449, enumerated as an "organization" on June 10, 2015.
The provider is located at 34 S CENTRE ST SOUTH ORANGE, NJ 07079 and the phone number is (973) 763-7248.
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.
