Parkside Medical Center

LBN: Khaleidoscope Health Care Inc.
Parkside Medical Center is an health care organization with primary practice located at 127 Lafayette St , Jersey City NJ 07304-3615. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Khaleidoscope Health Care Inc. can be contacted via phone (201) 451-5425, or through Blake, Larry M via phone (201) 386-9264.

Contact Information

Primary practice address
127 Lafayette St Jersey City NJ 07304-3615
Phone: (201) 451-5425
Fax: (201) 451-7499
Website:
Map and Directions
Authorized official contact:
Name: Blake, Larry M Licensed Clinical Social Worker (LCSW)
Phone: (201) 386-9264

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 80305 New Jersey

Profile Details

NPI number 1306969787
LBN Legal business name Khaleidoscope Health Care Inc.
DBA Doing business as Parkside Medical Center
Authorized official Blake, Larry M Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2007
Last updated Nov 27th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1306969787 NPPES
New Jersey MEDICAID 7864108
New Jersey MEDICAID 6103201

Popular Providers