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Organization

LADACIN NETWORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA CARLESIMO (EXECUTIVE DIRECTOR)
(732) 493-5900
Entity
Organization

Contact information

Practice address
1701 KNEELEY BLVD, OCEAN, NJ 07712-7622
(732) 493-5900
Mailing address
1703 KNEELEY BLVD, OCEAN, NJ 07712-7622
(732) 493-5900
(732) 493-5980

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053790519
NJ
05
1245619709
NJ
05
1396966438
NJ
05
1588834550
NJ
05
1700265261
NJ
05
1780063248
NJ
05
1932379906
NJ
Enumeration date
06/02/2015
Last updated
06/02/2015
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