Provider Demographics
NPI:1063543239
Name:OCCUPATIONAL CENTER OF UNION COUNTY, INC
Entity type:Organization
Organization Name:OCCUPATIONAL CENTER OF UNION COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-241-7200
Mailing Address - Street 1:301 COX ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1703
Mailing Address - Country:US
Mailing Address - Phone:908-241-7200
Mailing Address - Fax:908-241-2025
Practice Address - Street 1:301 COX ST
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1703
Practice Address - Country:US
Practice Address - Phone:908-241-7200
Practice Address - Fax:908-241-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ900500105251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0033405Medicaid
NJ654191Medicare ID - Type Unspecified
NJE63787Medicare UPIN