Epic Medical Daycare

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

License

R074780 Issued in NJ

Legal business name

EPIC MEDICAL DAYCARE

Practice address

39 Forest St
Lower Level
Montclair, NJ 07042-3550

Phone

(973) 342-6904

NPI assigned

Nov 19, 2013

Last updated

Dec 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Harris

Title

Owner

Phone

(973) 342-6904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1447680020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FOREST ST",
            "address_2": "LOWER LEVEL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423550",
            "telephone_number": "973-342-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FOREST ST",
            "address_2": "LOWER LEVEL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423550",
            "telephone_number": "973-342-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC MEDICAL DAYCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-342-6904"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NJ",
            "license": "R074780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child Intellectual and/or Developmental Disabilities Respite Care in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.