Active NPI
Senior Spirit of Roselle Park
- Adult Day Care Clinic/Center
- Roselle Park, NJ
National Provider Identifier
1245384916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- License
- 908117
- Legal business name
- SENIOR SPIRIT OF ROSELLE PARK
- Practice address
- 430 East Westfield Avenue
Roselle Park, NJ 07204 - Phone
- (908) 241-9393
- Fax
- (908) 620-1899
- NPI assigned
- Jan 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Enrique R. Giordano
- Title
- Managing Member
- Phone
- (732) 882-1188
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 908117 | NJ | Primary |
Addresses
Primary practice location
430 East Westfield Avenue
Roselle Park, NJ 07204
Mailing address
28 Gibson Blvd
Clark, NJ 07066
Phone (732) 882-1188
National Provider Directory
National Provider DirectoryLocations
28 Gibson Blvd
Clark, NJ 07066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304899200000",
"number": "1245384916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 GIBSON BLVD",
"city": "CLARK",
"state": "NJ",
"postal_code": "07066",
"telephone_number": "732-882-1188",
"fax_number": "732-882-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 EAST WESTFIELD AVENUE",
"city": "ROSELLE PARK",
"state": "NJ",
"postal_code": "07204",
"telephone_number": "908-241-9393",
"fax_number": "908-620-1899"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR SPIRIT OF ROSELLE PARK",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-22",
"last_updated": "2011-05-09",
"status": "A",
"authorized_official_last_name": "GIORDANO",
"authorized_official_first_name": "ENRIQUE",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "732-882-1188",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "NJ",
"license": "908117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roselle Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.