Provider Demographics
NPI:1215348362
Name:LASZLO CENTER 4 HOPE & HEALING
Entity type:Organization
Organization Name:LASZLO CENTER 4 HOPE & HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASZLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-794-3629
Mailing Address - Street 1:367 OLD BRIDGE TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2349
Mailing Address - Country:US
Mailing Address - Phone:732-794-3629
Mailing Address - Fax:
Practice Address - Street 1:367 OLD BRIDGE TPKE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2349
Practice Address - Country:US
Practice Address - Phone:732-794-3629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00153800101YA0400X
NJ37LC00063900101YA0400X
NJ37LC00203400101YA0400X
NJ44SC051652001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty