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Community Access Unlimitd Inc

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Elizabeth, NJ

NPI 1982124996 · NPPES record last updated Jun 21, 2017

Key facts

NPI
1982124996
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
COMMUNITY ACCESS UNLIMITD INC
Practice address
116 W Grand St Apt 104
Elizabeth, NJ 07202-1400
Phone
(908) 354-3040
NPI assigned
Jun 21, 2017
Organization subpart
No

Authorized official

Name
Sidney Blanchard
Title
Executive Director
Phone
(908) 354-3040

Corporate family (same tax ID) 12

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

National Provider Directory

Tax ID family
Community Access Unlimited (149 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

116 W Grand St Apt 104
Elizabeth, NJ 07202-1400

Mailing address

80 W Grand St
Elizabeth, NJ 07202-1471
Phone (908) 354-3040

Other identifiers

IdentifierTypeStateIssuer
0374725MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 21, 2017.

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1982124996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W GRAND ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021471",
            "telephone_number": "908-354-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W GRAND ST APT 104",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021400",
            "telephone_number": "908-354-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ACCESS UNLIMITD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "908-354-3040"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0374725",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

All providers in Elizabeth, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

Sources for this page

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