PERSONALIZED POTENTIAL CENTER NPI 1093229064

NPI Information

NPI: 1093229064
Provider Name: PERSONALIZED POTENTIAL CENTER
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
20 ROOSEVELT AVE
ELMWOOD PARK, NJ
ZIP 07407
Phone: (201) 956-0039
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PERSONALIZED POTENTIAL CENTER is a developmental disabilities clinic center in Elmwood Park, NJ. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). PERSONALIZED POTENTIAL CENTER NPI is 1093229064. The provider is registered as an organization entity type.

The provider's business location address is:

20 ROOSEVELT AVE
ELMWOOD PARK, NJ
ZIP 07407-031
Phone: (201) 956-0039

The provider's authorized official is Megan Pioch .
The authorized official title is Chief Operating Officer and has the following contact phone number (201) 956-0039.

The enumeration date for this NPI number is 11/28/2017 and was last updated on 11/29/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251C00000X	Day Training, Developmentally Disabled Services		No
2	261QA0600X	Clinic/Center	Adult Day Care	No
3	261QD1600X	Clinic/Center	Developmental Disabilities	Yes
4	261QH0700X	Clinic/Center	Hearing and Speech	No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
6	261QM1300X	Clinic/Center	Multi-Specialty	No
7	261QP2000X	Clinic/Center	Physical Therapy	No
8	261QR0400X	Clinic/Center	Rehabilitation	No
9	261QX0100X	Clinic/Center	Occupational Medicine	No
10	305R00000X	Preferred Provider Organization		No
11	305S00000X	Point of Service		No
12	347C00000X	Private Vehicle		No
13	385H00000X	Respite Care		No
14	332900000X	Non-Pharmacy Dispensing Site		No
15	251S00000X	Community/Behavioral Health		No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	NEW JERSEY	ALL OTHER INSURANCE COMPANIES
2	=========	MEDICAID	NEW 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: 5/5/2024

NPI Synchronization or Removal

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