Provider Demographics
NPI:1073646352
Name:COPE CENTER, INC.
Entity type:Organization
Organization Name:COPE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SEIDENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCADC
Authorized Official - Phone:973-783-6655
Mailing Address - Street 1:104 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4723
Mailing Address - Country:US
Mailing Address - Phone:973-783-6655
Mailing Address - Fax:973-783-1658
Practice Address - Street 1:104 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4723
Practice Address - Country:US
Practice Address - Phone:973-783-6655
Practice Address - Fax:973-783-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22203261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7609604Medicaid
NJ7609604Medicaid