Basic Information
| Provider Information | |||||||||
| NPI: | 1437672490 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OCCUPATIONAL CENTER OF UNION COUNTY, INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | INROADS TO OPPORTUNITIES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 COX ST | ||||||||
| Address2: | |||||||||
| City: | ROSELLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 072031703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082417200 | ||||||||
| FaxNumber: | 9082412025 | ||||||||
| Practice Location | |||||||||
| Address1: | 287 COX STREET | ||||||||
| Address2: | |||||||||
| City: | ROSELLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082417200 | ||||||||
| FaxNumber: | 9082412025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2017 | ||||||||
| LastUpdateDate: | 07/21/2017 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PEAR | ||||||||
| AuthorizedOfficialFirstName: | GIPSY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MIS COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9082417200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | OCCUPATIONAL CENTER OF UNION COUNTY, INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | 06XW | NJ | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.