Organization
FAMILY SENIOR HEALTH LLC
Active
Other names
Senior Spirit DDD
Organization subpart
No
Provider details
NPI number
Authorized official
LUISA UBIERA (ADMINISTRATOR)
(201) 761-0280
Entity
Organization
Contact information
Practice address
675 GARFIELD AVE, JERSEY CITY, NJ 07305-4239
(201) 761-0280
(201) 761-0290
Mailing address
675 GARFIELD AVE, JERSEY CITY, NJ 07305-4239
(201) 761-0280
(201) 761-0290
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071897
—
NJ
Enumeration date
08/10/2020
Last updated
08/10/2020
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