Organization
COMUNIDAD UNIDA PARA REHABILITACION DE ADICTOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA PLAZA (PRESIDENT&CEO)
(973) 622-3570
Entity
Organization
Contact information
Practice address
73 LINCOLN PARK, NEWARK, NJ 07102-2303
(973) 622-3570
(973) 622-1780
Mailing address
35 LINCOLN PARK, NEWARK, NJ 07102-2390
(973) 622-3570
(973) 622-1780
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
25MA03441900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0988308-01
—
NJ
05
—
7606001
—
NJ
01
—
D96709
MEDICAID UPIN
NJ
Enumeration date
11/15/2007
Last updated
06/05/2012
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