| Innovative Community Access Inc | |
|
272 Prospect Ave Park Ridge NJ 07656-2515 | |
| (201) 486-9500 | |
| Not Available |
| Full Name | Innovative Community Access Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 272 Prospect Ave, Park Ridge, New Jersey |
| Authorized Official Name and Position | Regina Ardizone (OWNER) |
| Authorized Official Contact | 2014869500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Community Access Inc 272 Prospect Ave Park Ridge NJ 07656-2515 Ph: (201) 486-9500 | Innovative Community Access Inc 272 Prospect Ave Park Ridge NJ 07656-2515 Ph: (201) 486-9500 |
| NPI Number | 1700270212 |
|---|---|
| Provider Enumeration Date | 03/23/2015 |
| Last Update Date | 03/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700270212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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