Provider Demographics
NPI:1528473709
Name:OPEN DOORS UNLIMITED
Entity type:Organization
Organization Name:OPEN DOORS UNLIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-621-3372
Mailing Address - Street 1:235 TERRACE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3253
Mailing Address - Country:US
Mailing Address - Phone:201-621-3372
Mailing Address - Fax:973-850-6005
Practice Address - Street 1:235 TERRACE LAKE DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-3253
Practice Address - Country:US
Practice Address - Phone:201-621-3372
Practice Address - Fax:973-850-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO11190600251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJA4960316OtherOXFORD