Organization Active NPI

Senior Spirit of Roselle Park

  • Adult Day Care Clinic/Center
  • Roselle Park, NJ
National Provider Identifier
1245384916
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
908117 Issued in NJ
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

Updated by the provider on May 9, 2011

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.