Provider Demographics
NPI:1992531578
Name:AMAZING U COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:AMAZING U COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-571-7898
Mailing Address - Street 1:1224 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2612
Mailing Address - Country:US
Mailing Address - Phone:646-571-7898
Mailing Address - Fax:
Practice Address - Street 1:1018 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6000
Practice Address - Country:US
Practice Address - Phone:646-571-7898
Practice Address - Fax:973-629-1418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health