Provider Demographics
NPI:1528670619
Name:NORTH JERSEY FRIENDSHIP HOUSE INC
Entity type:Organization
Organization Name:NORTH JERSEY FRIENDSHIP HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AURIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:201-488-2121
Mailing Address - Street 1:125 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4135
Mailing Address - Country:US
Mailing Address - Phone:201-488-2121
Mailing Address - Fax:201-488-7161
Practice Address - Street 1:45 URBAN CLUB RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2000
Practice Address - Country:US
Practice Address - Phone:973-987-3278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023507Medicaid
NJ0512583Medicaid