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RENAISSANCE CHALLENGE CONQUERORS TRAINING CENTER NPI 1437365368


NPI Information

NPI: 1437365368
Provider Name: RENAISSANCE CHALLENGE CONQUERORS TRAINING CENTER
Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
400 7TH AVE W
NEWARK, NJ
ZIP 07107
Phone: (973) 481-3431
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RENAISSANCE CHALLENGE CONQUERORS TRAINING CENTER is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Newark, NJ. RENAISSANCE CHALLENGE CONQUERORS TRAINING CENTER NPI is 1437365368. The provider is registered as an organization entity type.

The provider's business location address is:

400 7TH AVE W
NEWARK, NJ
ZIP 07107-697
Phone: (973) 481-3431

The provider's authorized official is Thomas Reddick .
The authorized official title is Executive Director and has the following contact phone number (973) 481-3431.

The enumeration date for this NPI number is 5/15/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)2000034NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10060356MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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