Organization
PARENT ASSOCIATE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA A DIAZ MATOS (PRESIDENT, OWNER)
(973) 345-4998
Entity
Organization
Contact information
Practice address
777 MADISON AVE, PATERSON, NJ 07501-2409
(973) 345-4998
(973) 345-4998
Mailing address
794 MADISON AVE, PATERSON, NJ 07501-2409
(973) 345-4998
(973) 345-4998
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
NJ
Other
Enumeration date
11/02/2012
Last updated
11/29/2012
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