Organization
STP UP-4 DEVELOPMENTAL DISABILITIES
Active
Other names
Bergen-Hudson Lerning Center
Organization subpart
No
Provider details
NPI number
Authorized official
LEONOR JAVIER BS-SOCIAL WORK (CEO)
(201) 647-0407
Entity
Organization
Contact information
Practice address
9060 PALISADE AVE, SUITE003, NORTH BERGEN, NJ 07047-6137
(201) 647-0407
Mailing address
2339 HUDSON TER, SIUTTE B5-A, FORT LEE, NJ 07024-7930
(201) 647-0407
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
QUALIFIED PROVIDER
NJ
347C00000X
Private Vehicle
QUALIFIED PROVIDER
NJ
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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