Organization
CANELAVILLE HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLFFI CANELA MBA (EXECUTIVE DIRECTOR)
(732) 925-2407
Entity
Organization
Contact information
Practice address
611 HIDDEN VILLAGE DR, PERTH AMBOY, NJ 08861-3367
(732) 925-2407
Mailing address
243 BROADWAY UNIT 9188, NEWARK, NJ 07104-7408
(732) 925-2407
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/18/2020
Last updated
11/27/2020
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