| NPI | 1083911507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURT MICHAEL LACIVITA Owner 201-923-7533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: NJ 46TR00395600) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-02-18 |