NPIMap

Organization Active NPI

Community Action for Independent Living, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Elizabeth, NJ
National Provider Identifier
1184005647
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
GH1064 Issued in NJ
Legal business name
COMMUNITY ACTION FOR INDEPENDENT LIVING, INC.
Practice address
63 Princeton Rd
Elizabeth, NJ 07208-1340
Phone
(908) 351-4915
Fax
(908) 962-9445
NPI assigned
Jun 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michele Difabio
Title
Controller
Phone
(973) 564-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH1064 NJ Primary

Addresses

Primary practice location

63 Princeton Rd
Elizabeth, NJ 07208-1340

Mailing address

1 Cornell Pkwy
Springfield, NJ 07081-3561
Phone (973) 564-7557

Other names 1

  • InterServ Services, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Community Action for Independent Living Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1184005647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORNELL PKWY",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070813561",
            "telephone_number": "973-564-7557",
            "fax_number": "973-467-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PRINCETON RD",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081340",
            "telephone_number": "908-351-4915",
            "fax_number": "908-962-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ACTION FOR INDEPENDENT LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "DIFABIO",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "973-564-7557"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "GH1064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InterServ Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.