# ZMA REHABILITATION SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083911507
- **Authorized official:** MR. BURT MICHAEL LACIVITA MS OTR (OWNER)
- **Authorized official phone:** (201) 923-7533

## Contact information

- **Practice address:** 81 NORTHFIELD AVE, SUITE 104, WEST ORANGE, NJ 07052-5342
- **Practice address phone:** (973) 325-0229
- **Practice address fax:** (973) 325-1105
- **Mailing address:** 141 S CENTRE ST, SOUTH ORANGE, NJ 07079-2609
- **Mailing address phone:** (201) 923-7533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | 46TR00395600 | NJ | Yes |

## Other

- **Enumeration date:** 02/18/2011
- **Last updated:** 02/18/2011