Organization
NEWARK AIDS CONSORTIUM, INC
Active
Other names
Broadway House for Continuing Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES R. GONZALEZ (PRESIDENT / CEO)
(973) 268-9797
Entity
Organization
Contact information
Practice address
298 BROADWAY, NEWARK, NJ 07104-4003
(973) 268-9797
(973) 483-0418
Mailing address
298 BROADWAY, NEWARK, NJ 07104-4003
(973) 268-9797
(973) 483-0418
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060738
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6400400
—
NJ
Enumeration date
07/19/2005
Last updated
01/06/2017
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