Organization
LADACIN NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA CARLESIMO (EXECUTIVE DIRECTOR)
(732) 493-5980
Entity
Organization
Contact information
Practice address
2550 ASBURY AVE APT 2, NEPTUNE, NJ 07753-2570
(732) 493-5900
(732) 493-5980
Mailing address
1703 KNEELEY BLVD, OCEAN, NJ 07712-7622
(732) 493-5900
(732) 493-5980
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0474533
—
NJ
05
—
1083094395
—
NJ
05
—
1114307436
—
NJ
05
—
1205216520
—
NJ
05
—
1245619709
—
NJ
05
—
1295115517
—
NJ
05
—
1396966438
—
NJ
05
—
1588044895
—
NJ
05
—
15888345550
—
NJ
05
—
1629458146
—
NJ
05
—
1700265261
—
NJ
05
—
1780063248
—
NJ
05
—
1811376395
—
NJ
05
—
1811377138
—
NJ
05
—
1881074292
—
NJ
05
—
1932379906
—
NJ
05
—
1962867507
—
NJ
05
—
1962882274
—
NJ
05
—
1992185409
—
NJ
Enumeration date
10/30/2017
Last updated
10/30/2017
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