Organization
INNOVATIVE COMMUNITY ACCESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINA ARDIZONE OTR (OWNER)
(201) 486-9500
Entity
Organization
Contact information
Practice address
272 PROSPECT AVE, PARK RIDGE, NJ 07656-2515
(201) 486-9500
Mailing address
272 PROSPECT AVE, PARK RIDGE, NJ 07656-2515
(201) 486-9500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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